Epiglottic Cyst Research Articles

Low-Temperature Plasma Radiofrequency Ablation for Congenital Epiglottic Cysts.

Objectives: Congenital epiglottic cysts are rare disorders of the larynx with symptoms such as laryngeal stridor and inspiratory dyspnea and are life-threatening in severe cases. This study aimed to investigate the usefulness of low-temperature plasma radiofrequency ablation for congenital epiglottic cysts and provide a reference for clinicians to develop treatment options. Methods: The clinical data of children (n = 7, 4 males and 3 females) with congenital epiglottic cysts, who were admitted to the Second Affiliated Hospital of Wenzhou Medical University and Yuying Children's Hospital from March 2018 to March 2023, were analyzed retrospectively. Following preoperative examinations, all patients underwent low-temperature plasma radiofrequency ablation under general anesthesia, and the curative effect was evaluated. Following surgery, regular patient follow-up examinations were conducted to monitor recurrence. Results: The age at the time of operation ranged from 1 day to 99 days, with an average of 37.57 ± 35.01 days. The surgical procedure was successfully completed in all the children; dyspnea disappeared and no surgical complications were observed. In addition, during the postoperative follow-up period of 6 months to 5 years, recurrence was not observed. Conclusions: Low-temperature plasma radiofrequency ablation is a safe and effective procedure for treating congenital epiglottic cysts and deserves clinical application and promotion.

Case Reports of Low-Temperature Plasma Radiofrequency Treatment for Congenital Epiglottic Cysts in Neonates and Infants.

An uncommon benign condition in neonates, known as congenital epiglottic cyst, can lead to symptoms such as neonatal dyspnea, laryngeal stridor, and, in severe cases, even pose a potential threat of asphyxia-related mortality. A congenital epiglottic cyst is one of the neonatal emergencies. Fibrolaryngoscopy is the predominant method of diagnosis, and early identification, diagnosis, as well as treatment are the key points. Successful endoscopic ablation of congenital epiglottic cysts in 3 newborns was achieved through the utilization of a low-temperature plasma radiofrequency ablation system. Consequently, the purpose of this case report is to assist pediatric emergency physicians in the timely identification of congenital epiglottic cysts with the potential risk of mortality and to provide additional experience in clinical management.

Misdiagnosis of thyroid penetration caused by fishbone ingestion: a case report and literature review

Foreign body ingestion is a common occurrence. However, thyroid penetrating injury caused by fishbone migration is rare. In this study, we present a rare misdiagnosed case of a fishbone fixed in the thyroid with a negative diagnosis on laryngoscopy examination. A 52-year-old woman experienced severe and persistent left anterior cervical pain when eating fish. Laryngoscopic imaging at an external hospital, revealed a cyst with a maximum length of 2 cm on the epiglottis, and epiglottic cyst resection under a laryngoscope was performed. The pain was not relieved, and the patient was referred to our hospital. Computed tomography and ultrasound examinations showed a sloping foreign body with a length of approximately 2.5 cm from top to bottom in the left lobe of the thyroid gland. The possibility of a penetrating fishbone injury was considered, and the foreign body was surgically removed. Postoperative drainage, fasting, and antibiotics were prescribed for 3 days, and then the patient was discharged. Follow-ups for 40 days suggested that she had recovered well without complications. The presence of a migratory fishbone should be considered when a patient has a history of fishbone ingestion but laryngoscopy or esophagoscopy assessment of foreign body ingestion is negative.

Clinical effect of CO2 laser resection of the epiglottic cyst under micro-laryngoscope suspension

Background Epiglottic cysts are common diseases and have multiple morbidity, and traditional surgery causes intraoperative bleeding and postoperative recurrence. Objective To investigate the therapeutic effect of CO2 laser resection on epiglottic cyst when compared with traditional surgery. Method Eighty patients with epiglottic cysts were randomly enrolled into the CO2 laser group (44 patients) and the high-frequency electrocautery group (36 patients). Results The CO2 laser group had a shorter operation time, less blood loss and fewer intraoperative ruptured cysts (p < .05). The duration of sore throat and the time before wound redness and swelling subsidence in the CO2 laser group were significantly shorter than those in the high-frequency electrocautery group (p < .05). Within one year after the operation, the incidence of epiglottic scar contracture in the CO2 laser group was significantly lower than that in the high-frequency electrocautery group (p < .05). Conclusion The CO2 laser group has the advantages of minimally invasive, less bleeding, short operation time and less postoperative complications, and it is worthy of applying as clinical routine to treat epiglottic cysts.

Epiglottic Cyst Treated with Electrocautery: A Case Report

Epiglottic Cyst Treated with Electrocautery: A Case Report

Characteristics of lingual thyroglossal duct cysts under flexible laryngoscopy and treatment approaches

ObjectivesLingual thyroglossal duct cysts (LTGDCs) are clinically rare and easily misdiagnosed as epiglottic cysts. Misdiagnosis leads to mistreatment; thus,simple diagnosis is important. This study aimed to investigate the characteristics of LTGDCs with flexible laryngoscopy and imaging, improve their diagnosis and explore surgical methods for patients undergoing an initial operation and patients with recurrence. MethodsIn total, 10 patients with LTGDCs were admitted from April 2014 to December 2020.By reviewing the diagnosis and treatment of the first typical case, the characteristics of LTGDC under flexible laryngoscopy were summarized. According to these characteristic manifestations, a clinical diagnosis of LTGDC was made correctly in the other 9 patients. All 10 patients underwent preoperative CT of the neck and sagittal reconstruction and thyroid ultrasound. ResultsOf the 10 patients, the first 2 patients had recurrent LTGDCs after several operations and underwent Sistrunk surgery. The remaining 8 patients were newly diagnosed and underwent endoscopic radical resection with low-temperature coblation; of these patients, 7 had no recurrence, and 1 underwent Sistrunk surgery after developing short-term recurrence. All patients were followed up for 5 months to 6 years after the last operation and were without recurrence. ConclusionLTGDCs are easily misdiagnosed as epiglottic cysts in the clinic. A correct clinical diagnosis can be made based on the characteristics according to flexible laryngoscopy. To determine the relationship between the cyst and hyoid bone, CT was performed. The surgical method was chosen based on the relationship between the cyst and hyoid bone and history of recurrence.

Clinical and Microbiological Factors Associated With Abscess Formation in Adult Acute Epiglottitis.

To evaluate clinical and microbiological findings that are correlated with abscess formation in adult acute epiglottitis (AE). We reviewed 140 cases of adult AE. Demographic, clinical, imaging, and microbiological findings are analyzed for all patients with AE in comparison to those with epiglottic abscess (EA). A total of 113 patients presented with AE and 27 presented or progressed to EA (19.3%). Age, sex, seasonality, smoking, body mass index (BMI), and comorbidities were statistically insignificant between the 2 groups. Muffled voice (P < .013), respiratory distress (P < .001), and pre-existence of epiglottic cyst (P < .001) are symptoms and signs connected with abscess formation. A total of 120 patients were treated conservatively. Surgical treatment was performed on 20 patients with EA. About 72 out of 80 cultures revealed monomicrobial infection. Mixed flora was isolated in 8 patients with EA. Streptococcus was isolated in 51 out of 80 positive cultures (64%). Haemophilus Influenza (Hib) was not isolated in any sample. EA and mixed flora relates to a higher rate of airway intervention (P < .001). A high level of suspicion for abscess formation is required if clinical examination reveals dyspnea, muffled voice, or an epiglottic cyst in adult with AE. The existence of EA doubles the duration of hospitalization. EA is typically found on the lingual surface of the epiglottis. Supraglottic or deep neck space expansion should be treated surgically. EA is associated with a mixed flora and a higher rate of airway obstruction. Streptococcus is discovered to be the most common pathogen.

Resonance Characteristics in Epiglottic Cyst: Formant Frequency, Vowel Space Area, Vowel Articulatory Index, and Formant Centralization Ratio

ObjectivesResonance characteristics can change due to alterations in the shape of the vocal tract in patients with epiglottic cysts. This study aimed to analyze the resonance characteristics before and after the surgical excision of epiglottic cysts. MethodsTwelve male patients with epiglottic cysts were enrolled in this study. We analyzed the first and second formants (F1 and F2) in vowels /a/, /e/, /i/, /o/, and /u/, vowel space area (VSA), vowel articulatory index (VAI), and formant centralization ratio (FCR). We measured these parameters before and after the surgical excision of epiglottic cysts. ResultsThere was a significant increase in the F1 values of /a/, VSA, and VAI, and a significant decrease in the value of FCR after the surgery. ConclusionWe confirmed the change in the resonance characteristics in patients with epiglottic cysts. It is considered that further studies on epiglottic cysts and resonance changes are needed in the future.

A Retrospective Case Series of Anesthetic Patients With Epiglottic Cysts.

Previously undiagnosed or asymptomatic epiglottic cysts may be coincidentally detected during intubation. This retrospective case series identified undiagnosed epiglottic cysts that were discovered during intubation in 4 patients who underwent oral surgery under general anesthesia at our hospital during a 6-year period. Including 2 additional cases, 1 previously diagnosed and 1 detected during preoperative imaging, epiglottic cysts were observed in 6 of 1112 cases (0.54%) total. Among the undiagnosed epiglottic cyst cases, mild dyspnea on effort or snoring was reported in 2 patients, but all others were asymptomatic. Upon discovering previously undiagnosed epiglottic cysts during intubation, it is essential to proceed cautiously, remain alert for potential airway management difficulties, and avoid injuring or rupturing the cysts. In addition, any available preoperative imaging should be reviewed as information pertinent to the airway and any abnormalities may be useful. This report discusses the anesthetic care of 6 patients with epiglottic cysts that were previously known or initially discovered during intubation.

Multiple Epidermal Inclusion Cysts of Epiglottis

Epiglottic cysts are benign laryngeal lesions. Though congenital cysts are often life-threatening, they are usually painless and symptomless in adults, or present with slight, though perceptible, interference with either swallowing or speaking or respiration. Early recognition and diagnosis by routine mirror laryngoscopy is advocated. Prompt removal or draining is the treatment. This is a case report of 42-year-old woman with complaints of feeling of something in throat, sleep apnoea and hoarseness, who on routine mirror laryngoscopy was found to have two large cysts arising from the free border of the epiglottis. The final histopathology reported the cysts as epidermal inclusion cysts.

A new transoral modality for the treatment of lingual thyroglossal duct cyst with suspension laryngoscopy by plasma coblation.

Lingual thyroglossal duct cysts (LTGDC) are a rare kind of thyroglossal duct cyst. However, Sistrunk surgery is not very suitable for this type of cyst. This study aimed to explore the efficacy of transoral excision of LTGDC by plasma coblation. The present study reviewed 11 patients, comprising seven males and four females, who had been diagnosed with LTGDC preoperatively by computed tomography (CT) and fibre-optic electronic laryngoscopy. Of those patients, two had recurrence after surgery of epiglottic cysts. All these patients underwent transoral excision by plasma coblation. Then, we collected preoperative data of the patients, observed the effect of surgery, and analysed factors relevant to LTGDC, including the estimated bleeding amount, postoperative hospitalisation, complications and recurrence rates. The connection between LTGDC and hyoid was tapered on sagittal images of CT, which was vital evidence for the diagnosis of LTGDC. Surgery was performed successfully for all 11 patients, and all recovered without complication. There was no evidence of recurrence after surgery, during follow up for 3-43months. Transoral surgery for LTGDC can be performed successfully by plasma coblation, which is an effective and safe surgical treatment. Fibre-optic electronic laryngoscopy and CT are essential to the diagnosis of LTGDC in order to avoid missing detection and misdiagnosis.

Anaesthetic Challenges in a Child Presenting with A Large Epiglottic Cyst for Excision

Laryngeal cysts are relatively rare benign lesions that represent approximately 5% of benign laryngeal lesions.1 Though benign, they can present with severe respiratory obstruction. We present one such rare case in a child aged 6yrs presenting with a large epiglottic cyst highlighting the anaesthetic challenges related to management of the airway in this age group. Fiberoptic intubation was planned in our case keeping all the necessary equipments in case of airway crisis.

Concomittant epiglottic and multiple vallecular cyst: An exceptioally rare case report

Laryngeal cysts are rare and are often diagnosed incidently as majority of the patients are symptom free or have nonspecific complaints. Here, we describe single large epidermoid inclusion epiglottic cyst and multiple small mucosal retention vallecular cysts presenting concomitantly which has not been described previously in literature.

Application of radiofrequency coblation under microscope in infantile epiglottic cyst

Objective:To explore the application of microscope combined with radiofrequency coblation in the treatment of infantile epiglottic cyst. Method:17 cases of infantile epiglottic cysts were treated with radiofrequency coblation under supporting laryngoscope and microscope. Result:All 17 patients were successfully resected the epiglottic cysts, without complications during and after surgery. The dyspnea symptoms disappeared at the time of discharge. The wounds healed well after reexamination at 1 month after operation. There was no recurrence in the 6-23 months follow-up. Conclusion:The treatment of infantile epiglottic cysts with radiofrequency coblation under microscope has many advantages, such as clear vision, strong three-dimensional sensation, stable operation of both hands, less bleeding, and light postoperative tissue reaction.

A case of laryngeal edema that developed during gastric endoscopic submucosal dissection and difficult tracheal intubation due to an epiglottic cyst

A 76-year-old male was scheduled for gastric endoscopic submucosal dissection (ESD) of early-stage gastric cancer. During the ESD procedure, hypoxemia caused by laryngeal edema occurred and ESD was discontinued. Emergency tracheal intubation was attempted but it was difficult due to the presence of a large epiglottic cyst. Using a McGRATH laryngoscope, tracheal intubation was managed successfully. He was treated with steroids for laryngeal edema, and was discharged to home without any sequelae. An epiglottic cyst is a risk factor for difficult intubation. In patients who are scheduled for upper endoscopic treatment that requires sedation, a large epiglottic cyst should be removed before treatment.

Videolaryngoscope-assisted coblation of epiglottic cysts.

This study aims to investigate the safety and effectiveness of videolaryngoscope-assisted coblation of epiglottic cysts (VACECs) under general anesthesia. Twenty-eight consecutive patients with epiglottic cysts (ECs), underwent VACECs in this prospective clinical series from January 2015 to March 2019. The pre-operative electronic flexible laryngoscopic or 70° rigid laryngeal endoscopic examination was carried out to assess the location and size of ECs. There was a periodical follow-up survey for all patients. A total 28 of patients were enrolled, including 12 men and 16 women, with an average age of 55 (range 24-78). The patient's medical history ranged from half a month to 2years. The size of the cyst arranged from 0.8 to 1.5cm. All patients were cured without pharyngeal or systemic complications. No tooth loss occurred in five patients (17.9%) with loose anterior teeth. Specimen pathology confirmed the diagnosis in all patients. No recurrence was found after more than half a year's follow-up. VACECs brings together the advantages of videolaryngoscope and coblation. It is a simple, safe and feasible procedure for patients with ECs and is worthy of clinical application.

Endoscopic Technique for Management of Large Epiglottic Cyst - A Novel Approach

Endoscopic Technique for Management of Large Epiglottic Cyst - A Novel Approach

Curative effect observation of application of the snare in epiglottic cystectomy by arc-shaped laryngoscopy

Objective:To evaluate the effect of the epiglottic cystectomy by arc-shaped video laryngoscopy combined with snare. Method:The clinical data of 42 patients with epiglottic cysts were retrospectively analyzed. Forty-two patients with epiglottis cyst were treated by arc-shaped video laryngoscopy combined with snare. Result:All 42 cases were completely resected at one time without obvious complications and the cure rate was 100%. Moreover, the short operation time（5-20 min） and the minor hemorrhage（1-10 ml） were observe. There was no recurrence after 6 to 33 months follow-up. Conclusion:The epiglottic cystectomy by arc-shaped video laryngoscopy combined with snare has the advantages of broad vision, easy operation, minimal invasion, rapid recovery and good curative effect, it is worthy to be popularized in clinical application.

Presentation, Management, and Outcome of Lingual Thyroglossal Duct Cyst in Pediatric and Adult Populations.

Lingual thyroglossal duct cysts (LTDCs) are rare congenital anomalies of the neck. The authors described the presentation, management, and outcome of LTDC in pediatric and adult cases through a retrospective observational analysis between 2008 and 2018. Data included patients' demographics, main complaint, preoperative investigations, surgical management, and recurrences. Seventeen patients were included: 8 pediatric and 9 adult patients. The most common presenting symptom was foreign body sensation (35.3%). In all, 50% (4/8) of the children had respiratory problems, while the most common symptom in adults was difficulty swallowing (8/9). Five patients were of recurrent LTDC; 3 referred patients were suspected of having recurrent epiglottic cysts. The total misdiagnosis rate was 35.3% (6/17): 14.3% (1/7) in children and 55.6% (5/9) in adults. Fiber optic laryngoscopic examination revealed that LTDCs mostly occurred at the base of the tongue (53.3%) and vallecula epiglottica (33.3%). Ultrasound examination revealed low to anechoic masses on the root of the tongue; 50% were regular in shape and 50% were irregular. All pediatric patients had regular masses (100%), but most adults had irregular masses (85.7%). In total, 76.5% of the patients underwent the Sistrunk procedure, and 23.5% underwent marsupialization alone. The mean follow-up length was 37.5 ± 32.8 months. All patients were well at follow-up. In conclusion, direct laryngoscopy and ultrasound examination are essential for diagnosis as LTDCs can be confused with vallecular cysts. Surgical treatment such as marsupialization or the Sistrunk operation must be performed thoroughly.

Micro flap technique: a novel approach for the management of a large epiglottic cyst

&lt;p&gt;Epiglottic cyst is a not an unusual disease in the larynx. Although the lesion is benign, airway obstruction may occur due to a large cyst both in children and adults. Therefore it should to be kept in mind in the differential diagnosis of stridor or difficulty in breathing. Common treatment modalities in dealing with these epiglottic cysts are endoscopic excision, marsupialization and even external approaches through neck in cases of very large cysts, complete Excision is usually the treatment of choice, with low recurrence. We report a case of a 38 years old man who presented with progressive difficulty in breathing, foreign body sensation and difficulty to swallow and the cyst was completely excised by s new micro flap technique, using both endoscope and microscope. The new method of excision of cyst after elevating the micro flaps and redraping on the raw surface causes faster healing process, less post operative edema and less post operative symptoms. The patient was discharged third day after the surgery without any complications. &lt;/p&gt;