Saccular Cyst Research Articles

A Case of Laryngeal Saccular Cyst Removed by Laryngomicrosurgery

A Case of Laryngeal Saccular Cyst Removed by Laryngomicrosurgery

Saccular Cyst of the Larynx - A Clinical Case

Saccular cyst of the larynx is a benign supraglottic lesion, filled with mucus. It forms from the laryngeal sac, which is a soft tissue mass that is an extension of the laryngeal ventricle. Due to the extreme rarity, the true prevalence of the disease is unknown, although congenital laryngeal cysts have been reported to affect 1 in 300,000 newborns. The gold standard for diagnosing of saccular laryngeal cysts is laryngoscopy. Treatment of saccular cysts can only be done surgically, using endoscopic or external access. It is believed that endoscopic CO2 laser excision is the treatment of choice.

A Case of Bilateral Multiple Laryngeal Saccular Cysts

A 54-year-old woman presented to us with the chief complaint of hoarseness. Laryngoscopy showed a submucosal mass in each of the ventricular bands on either side. Computed tomography showed a cystic lesion and laryngoscopic resection was planned. Intraoperative findings showed a cystic lesion in the bilateral ventricular bands, both of which were removed. The symptoms improved after the surgery, but 40 months later, the patient visited us again complaining of hoarseness. Laryngoscopy revealed a cystic lesion in the left ventricular band and oral laryngoscopic removal was performed again, and based on the microscopic and pathological findings, a diagnosis of laryngeal saccular cyst was made. A laryngeal saccular cyst is a type of laryngeal cyst that occurs when the opening to the laryngeal cavity is obstructed. We encountered a case of bilateral multiple laryngeal saccular cysts and report the case herein, with a review of the literature. It is important to completely remove such cyst in order to prevent recurrence.

Saccular Cyst Resection via a Lateral Thyrotomy Approach-A Novel Application of the Ultrasonic Bone Aspirator.

Saccular Cyst Resection via a Lateral Thyrotomy Approach-A Novel Application of the Ultrasonic Bone Aspirator.

Benign Laryngeal Lesions

Benign laryngeal lesions represent a diverse set of pathologies whose clinical presentation may range from no symptoms to dyspnea and/or dysphonia. Flexible fiberoptic laryngoscopy and videolaryngostroboscopy are important in distinguishingdifferent types of lesions, and management and treatment are dependent on the identification of these lesions, as they have different etiologies. Some lesions such as vocal fold nodules and polyps are primarily phonotraumatic and may benefit fromspeech therapy and vocal hygiene as initial approaches. Vocal fold cysts and benign tumors may benefit from microlaryngeal approaches, while capillary ectasias, polypoid corditis, laryngoceles, saccular cysts, and papilloma may benefit from laser therapy. Vocal fold granulomas may arise from various etiologies such as intubation, traumatic behaviors, or reflux. Polypoid corditis arises from smoking. This review is intended to provide an overview of the variety of lesions that encompass non-malignant laryngeal lesions that is both suitable for junior and senior residents. This review contains 12 figures, 5 tables, and 64 references Keywords: Benign laryngeal lesions, Laryngocele, Polyp, Cyst, Polypoid Corditis, Papilloma

Atypical Presentation of a Combined Internal/External Saccular Cyst: A Case Report.

Atypical Presentation of a Combined Internal/External Saccular Cyst: A Case Report.

Fetoscopic Balloon Dilation and Cricotracheal Resection for Laryngeal Atresia in CHAOS.

View Supplementary Video 1 Laryngoscope, 131:660–662, 2021

Congenital laryngeal saccular cyst leading to stridor in a newborn: Think beyond laryngomalacia

Laryngomalacia is the most common congenital anomaly of the larynx leading to stridor in newborns. However, laryngeal cyst, although rare, should also be considered in the differential diagnosis of stridor. Hence, every newborn with stridor should undergo flexible/rigid endoscopic evaluation of the airway so that these rare entities are not missed, as its early recognition and proper treatment are essential because it can cause life-threatening airway obstruction. We describe a newborn presenting to us with stridor and severe respiratory distress since birth, who was successfully treated with no recurrence, with transoral microscopic complete excision of the laryngeal saccular cyst. We emphasize the importance of a good clinical history along with endoscopic evaluation of the airway in every neonate presenting with stridor with an unexpected evolution to determine the causal lesion.

Endoscopic surgical approach to laryngoceles and saccular cysts

Laryngeal saccular disorders are rare lesions presenting as abnormal saccular dilation, either mainly filled with air (laryngoceles) or fluid (saccular cysts). These are further categorized as internal when confined in the endolarynx, external, or combined. In adults, saccular disorders are mostly idiopathic with various reported proportion associated with laryngeal cancer or increased transglottic pressure. Patients may present with voice disorders, respiratory, or swallowing issues. Workup should include directed history taking, laryngeal endoscopy, neck examination, and imaging. Priority should be given for securing the airway when indicated. The endoscopic approach via direct laryngoscopy with complete resection (by cold, hot instruments, or CO2 laser) is the treatment of choice for internal saccular disorders or small combined ones. The transoral robotic approach was also recently reported. Needle aspiration or marsupialization can be performed by the less experienced surgeon and provide rapid decompression when needed, although with higher recurrence rates.

Open surgical approach to laryngoceles and saccular cysts

Saccular disorders extending beyond the thyrohyoid membrane are classified as external, or combined, based on to their extension beyond the thyrohyoid membrane and the proportion of the external to the internal component. The workup is the same as for internal saccular disorders and airway safety is of utmost importance. The open/transcervical approach is currently the treatment of choice for cases with relatively large external component. Endoscopic approach was also reported for combined lesions with a relatively smaller external component.

Clinical Characteristics and Management of Saccular Cysts: A Single Institute Experience

Objectives A saccular cyst is defined as a dilated saccule of the larynx, filled with mucus, and is located between the false vocal cords and the thyroid cartilage. Although this uncommon laryngeal condition is benign in nature, it could lead to dyspnea, stridor, and airway obstruction, depending on its size and location. Furthermore, some saccular cysts have been associated with laryngeal carcinoma. This study aimed to characterize this rather uncommon laryngeal condition to aid in determining the proper management of this pathology.Methods Medical records were retrospectively reviewed of all patients with saccular cysts diagnosed and treated between 2006 and 2017 at a tertiary otolaryngologic care center.Results Seven patients with saccular cysts were identified (male:female=2:5; mean age, 34.1 years); two were pediatric patients. Surgical intervention was performed in all patients by laryngo-microsurgery using CO2 laser. There was no recurrence after the initial surgical treatment.Conclusion Saccular cysts can be managed endoscopically using CO2 laser, without requiring an external approach. Therefore, an endoscopic approach should be actively considered for an optimal treatment outcome.

Congenital saccular cyst of the larynx: a case series.

BackgroundCongenital saccular cyst of the larynx is a very rare cause of respiratory obstruction in the neonatal period and in older children. It can be a potentially life-threatening condition. It can also present less dramatically later in childhood as a voice disorder. Early diagnosis and treatment are very important to avoid the high mortality associated with undiagnosed cases.Subjects and methodI report here two cases of laryngeal saccular cyst with different clinical scenarios. The first patient presented immediately after birth with respiratory problems and the second presented later at an older age. Both patients were managed with endoscopic excision.ConclusionCongenital saccular laryngeal cyst remains an important cause of respiratory obstruction in the neonate albeit being rare. It is amenable to treatment with minimally invasive procedures.

Congenital laryngeal saccular cyst: a case report and literature review

Introducción. El quiste sacular congénito es una lesión rara, pero benigna, dada por la dilatación del sáculo laríngeo que se llena de moco y que no se comunica con el lumen laríngeo. Según la literatura, su tratamiento definitivo es quirúrgico. Objetivo. Realizar una revisión de la literatura y el reporte de un caso de quiste sacular laríngeo congénito y su tratamiento mediante abordaje endoscópico y uso de radiofrecuencia.Materiales y métodos. Se realizó la presentación del caso clínico y se llevó a cabo una revisión de la literatura en las bases de datos de Pubmed y Tripdatabase usando palabras claves descritas.Resultados. Esta patología es escasa, con una incidencia de 1.82 casos por 100 000 nacidos vivos. El diagnostico se realiza por medio de endoscopia laríngea, imágenes o revisión de la clínica. El caso expuesto es de una paciente recién nacida que presenta estridor y dificultad respiratoria y es diagnosticada con quiste sacular laríngeo, el cual es resecado de forma quirúrgica por medio de endoscopia con uso de radiofrecuencia. El procedimiento da como resultado la no reaparición del quiste.Conclusiones. Pese a no existir muchos reportes de caso, hay que conocer las características del quiste sacular congénito para poder realizar el tratamiento adecuado con los recursos disponibles. Es posible realizar resección endoscópica de esta lesión si es <3cm por medio de radiofrecuencia, un método seguro y eficaz.

Potential Causative Factors for Saccular Disorders: Association with Smoking and Other Laryngeal Pathologies

To describe risk factors, clinical presentation, and outcome of patients with saccular disorders. Case control with chart review METHODS: A single center retrospective study. Case group included all adult patients, presenting with saccular disorders (saccular cyst or laryngocele), between the years 2010 and 2015. A matched group of patients with vocal fold cyst served as the control. Twenty-nine patients met the inclusion criteria: 15 males and 14 females; the mean age was 60.5(±11.2). The median follow-up period was 10 months (range 2-48). Overall, 75.9% (22) had a positive smoking history; 55.2% (16) were active and 20.7% (6) were past smokers. The median pack- years of all smokers in the saccular disorder group was 40 (range 1-67). Saccular disorder patients demonstrated significantly higher prevalence of active smoking when compared to control patients (55.2% versus 17.9%, P = 0.014). Sixty-nine percent of the patients had some synchronous vocal fold comorbidity. The leading vocal fold comorbidity was Reinke's edema in 41% (12). Synchronous vocal fold comorbidities were significantly more prevalent in smokers compared with nonsmokers-82% (18 of 22) and 29% (2 of 7), respectively (P = 0.008). Surgical treatment was performed on 26 patients; all of whom underwent complete resection, either by endoscopic (92%), external (4%), or combined external and endoscopic (4%) approaches. There was a single case of recurrence (4%), 10 months following initial resection. Saccular disorders are associated with smoking and synchronous vocal fold comorbidity. Complete resection is recommended as surgical outcome is excellent.

The clinical characteristics and surgical options of congenital laryngeal saccular cysts

Objective:To evaluate the clinical characteristics and surgical options for CLSCs.Method: Thirty-two CLSC patients underwent a total of 59 surgeries were recruited for this study. Needle aspiration was performed in 18 cases and excision of the roof in 9 cases. Except 1 case of open operation through cervical approach, 31 cases were underwent endoscopic procedure using CO₂ laser and microsuturing of the wound surfaces.Result: The time of recurrence depended on surgical approaches: 5-12 days for needle aspiration and 1-10 months for excicing roof of the cyst. No recurrence was found after the complete resection of the cyst wall using a CO₂ laser and microsuturing of the wound surfaces via an endoscopic procedure and open operation.Conclusion:CO₂ laser and microsuturing of the wound surfaces via an endoscope is a effective approach to cure and prevent recurrence of CLSCs.

Saccular cyst – Cause of intermittent stridor in a child: A case report

Saccular cyst is a rare lesion of larynx causing respiratory obstruction and stridor in neonates and infants. Herein we present a case of a 4year old who presented to us with intermittent respiratory distress and stridor. Fibreoptic bronchoscopy showed the presence of saccular cyst overhanging the anterior part of right vocal cord. Endoscopic marsupialization of cyst is done using laryngeal microdebrider with stripping of cyst lining. Saccular cyst should be considered in the differential diagnosis of children presenting with intermittent stridor.

Transoral robotic surgery for upper airway pathology in the pediatric population.

The purpose of this study is to present one of the largest case series of pediatric transoral robotic surgery (TORS) in the upper airway demonstrating a wide range of ages and indications. A retrospective case series at an academic tertiary referral center from August 2010 to September 2014. The da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) was used on 16 pediatric patients for 18 procedures. A variety of upper airway pathologies and reconstructions in children with a wide range of ages and weights were treated. No lingual tonsillectomies or base-of-tongue reductions were included. Sixteen children (6 males) underwent 18 TORS procedures, including resection of hamartoma (n = 1), repair of laryngeal cleft (n = 7), removal of saccular cyst (n = 2), release of pharyngeal or esophageal strictures (n = 2), and excision of lymphatic malformations (n = 4). Patient ages ranged from 14 days to 15 years. There were no intraoperative complications. All patients had successful robotic access, and no patients had conversions to open or traditional endoscopic surgery. Hospital courses varied with duration ranging from 1 to 20 days. The median follow up was 22 months. Applying TORS to the pediatric population can be feasible and safe for appropriate airway pathologies. Because many patients are small in size, there is inherent risk in using robotic instruments and scopes transorally. Pearls in this series include a standardized two-robot experienced attending team and longitudinal airway follow-up. 4 Laryngoscope, 127:247-251, 2017.

Virtual-tissue computer simulations define the roles of cell adhesion and proliferation in the onset of kidney cystic disease.

In autosomal dominant polycystic kidney disease (ADPKD), cysts accumulate and progressively impair renal function. Mutations in PKD1 and PKD2 genes are causally linked to ADPKD, but how these mutations drive cell behaviors that underlie ADPKD pathogenesis is unknown. Human ADPKD cysts frequently express cadherin-8 (cad8), and expression of cad8 ectopically in vitro suffices to initiate cystogenesis. To explore cell behavioral mechanisms of cad8-driven cyst initiation, we developed a virtual-tissue computer model. Our simulations predicted that either reduced cell-cell adhesion or reduced contact inhibition of proliferation triggers cyst induction. To reproduce the full range of cyst morphologies observed in vivo, changes in both cell adhesion and proliferation are required. However, only loss-of-adhesion simulations produced morphologies matching in vitro cad8-induced cysts. Conversely, the saccular cysts described by others arise predominantly by decreased contact inhibition, that is, increased proliferation. In vitro experiments confirmed that cell-cell adhesion was reduced and proliferation was increased by ectopic cad8 expression. We conclude that adhesion loss due to cadherin type switching in ADPKD suffices to drive cystogenesis. Thus, control of cadherin type switching provides a new target for therapeutic intervention.

Concomitant vallecular and saccular cysts: A rare entity

Benign laryngeal cysts have the potential to cause airway compromise. Proper anesthetic and surgical management should be planned in advance to avoid undue complications. We present a case of 52-year-old male with concomitant vallecular and saccular cysts (VaC and SC) which were managed successfully. To the best of our knowledge, this is the first report on concomitant existence of VaC and SC.

A Clinical Study of Laryngeal Cysts

ABSTRACT Aim To study cases of cysts of larynx and review the literature regarding precipitating factors and methods of treatment. Materials and methods A retrospective study of eight cases of cysts of larynx in our hospital was carried out from July 2012 to December 2015. In all cases, diagnosis was made by video laryngoscopy and was treated by microlaryngeal surgery under general anesthesia (GA). Results Eight patients with laryngeal cysts were identified, of which five were male and three were female. The mean age was ranging from 40 to 60. On examination, two were diagnosed with cysts from epiglottis, three from aryepiglottic folds, two from false vocal cords, and one from the ventricle. Conclusion As saccular cysts are identified to be associated with neoplastic transformation, it is important to recognize the laryngeal saccular cyst and manage appropriately in its early stages and to differentiate it from other laryngeal cysts. Thorough diagnostic evaluation and surgical intervention necessitates the appropriate management. How to cite this article Kumar Chowdary KVS, Srikanth N, Shaik FB. A Clinical Study of Laryngeal Cysts. Int J Phonosurg Laryngol 2016;6(2):53-56.