Supraglottic Cyst Research Articles

KTP-532 Laser Assisted Excision of a Rare Laryngeal Angiolipoma: A Case Report with Review of Literature.

Angiolipoma is a benign mesenchymal tumor and its occurrence in head and neck region is very rare. Only 2 cases of Laryngeal angiolipomas have been reported in the medical literature. We present one such rare case in a 32-year-old male who presented with complaints of change in voice and foreign body sensation in the throat since past 9months along with features suggestive of obstructive sleep apnoea and dysphagia. Contrast enhanced CT scan of the neck showed a cystic lesion arising from right ventricle extending superiorlytill the vallecula, partially obstructing the airway. Suspecting a supraglottic cyst, trans-oral microlaryngoscopic KTP-532 laser assisted excision was planned, intraoperatively a solid tumor was encountered. We discuss herein the clinical presentation and management of this rare neoplasm with review of literature.

A Rare Presentation of Congenital Aryepiglottic Cyst With Concurrent Laryngomalacia

Congenital laryngeal cyst remains a rare but possible cause of airway obstruction that requires urgent referral to an otorhinolaryngology centre. Vallecular cyst commonly present immediately after birth with variable degree of airway obstruction symptoms depending on its size, but presentation of aryepiglottic cyst with concurrent laryngomalacia remains a conundrum as there are very few cases reported. Unlike the more obvious manifestation of stridor or increasing respiratory effort in most supraglottic cyst or laryngomalacia, the neonate presented only with weak cry which masqueraded early suspicion and referral of an airway pathology. We provide discussion on the rare clinical presentation aryepiglottic cyst with synchronous laryngomalacia and its management.

Teratoma of larynx: case report

<p class="abstract">Teratomas are embryonal neoplasm arises from totipotent germ cells. They are having tissues from all the three blastodermic layers. There are various locations of congenital teratoma. Naso-oropharyngeal site teratoma are either sessile or pedunculated. We describe a rare case of laryngeal teratoma in a five years old patient presented with change in voice and breathing difficulty. On flexible laryngoscopy, it appeared like supraglottic cyst but on CT scan it was confirmed as teratoma. Pre-operative tracheostomy and transoral carbon dioxide laser assisted excision done. Histopathological examination showed osteoid trabeculae, chondroid tissue with loose myxoid islands and adipose tissue. No recurrence of tumor on 18 months follow-up. This is the first case report of pediatric larynx teratoma reported in present century.</p>

DOZ047.123: Choose typology: oral communication multiple congenital bronchogenic cysts and thyroglossal duct remnant, case report

Abstract Background Thyroglossal duct remnants, most frequently presenting as cysts, are the most common congenital anomalies of the neck. Bronchogenic cysts are rare congenital anomalies of the primitive foregut and are a subtype of foregut supplication cysts. Those cysts are the most common cystic lesions of the mediastinum. They can present in other areas such as the neck. Such cystic lesions are usually seen in pediatric population and symptomology depends on the location, size and degree of compression to the surrounding structures. The synchronous presence of both lesions in one patient is rare. To the best of our knowledge, such presentation has not been reported in the literature. We present a case of multiple lesions in the neck and mediastinum including precricoid, paraglotttic and paratracheal regions. Case Presentation A full-term male newborn presented in day 1 post normal vaginal delivery with progressive stridor and decreased feeding. Urgent airway endoscopy revealed a left supraglottic cyst and proximal non pulsatile tracheal wall compression by another cystic lesion. Aspiration of the supraglottic cyst was done and one month later, he developed stridor again for which he had endoscopic marsupialization of right supraglottic cyst and internal aspiration of paratracheal cyst. MRI showed right paratracheal cystic lesion with evidence of a tubular tract and an infected cyst inferiorly. Decision was made to explore the neck for definite removal of the cysts. Three lesions were identified: a precricoid mass, and paraglottic and paratracheal cysts. Cervical lesions were carefully dissected and excised. For the paratracheal cyst which extended to the mediastinum, incision and drainage was done and part of cyst wall was excised, and a drain inserted into the cyst. Histopathology confirmed the precrcoid lesion to be a thyroglossal duct remnant, the paraglottic cyst in keeping with bronchogenic cyst and the paratracheal cyst wall showed granulation tissue. Discussion The fact that the embryological basis for development of thyroglossal duct cyst and bronchogenic cyst is different makes diagnosis of both lesions is challenging and such presentation is unique. Definite diagnosis depends on accurate history, imaging particularly MRI and histopathology. Surgery is the treatment of choice for symptomatic cases.

Congenital supraglottic cyst presented with pneumothorax and pneumomediastinum: Case report

Congenital supraglottic cyst presented with pneumothorax and pneumomediastinum: Case report

Congenital Supraglottic Cyst with Stridor Immediately after Birth

ABSTRACT Congenital laryngeal cysts are rare with an estimated incidence of < 2 per 100,000 live births. We present here a case report of congenital supraglottic cyst arising from the glossoepiglottic fold that presented with respiratory distress immediately after birth. Direct laryngoscopic examination revealed a cyst in the left supraglottic area. Surgical resection was carried out and stridor disappeared following surgery. Congenital supraglottic cyst presenting with stridor immediately after birth is rarely documented but should be born in mind as a differential diagnosis. How to cite this article Das DJ, Bhatia A, Debbarma R, Sarma K. Congenital Supraglottic Cyst with Stridor Immediately after Birth. Int J Otorhinolaryngol Clin 2015;7(2):91-92.

Epiglottic and arytenoid cyst in a preterm infant: Case report and review of the literature

Abstract Supraglottic cysts are rare laryngeal lesions that can cause stridor, dysphagia, and fatal airway occlusion in infancy. Treatment is usually surgical with favorable prognosis. In this report, we present a case of a premature infant with supraglottic cyst in an unusual location that was successfully treated with endoscopic marsupialization.

Huge supraglottic cyst causing obstructive sleep apnea in an adult

Huge supraglottic cyst causing obstructive sleep apnea in an adult

Laryngeal cyst- case report.

Laryngeal cysts are rare, generally benign lesions which can affect all age groups. We report a case of huge supraglottic cyst. A 19 years old female presented with hoarseness and airway obstruction secondary to large cystic muss involving the entire right side of supraglottis attached to right aryepiglottic fold. Cyst was dissected by laryngofissure approach. On regular follow up for 3 years there is no recurrence of the lesion.

Large B-cell non-Hodgkin’s lymphoma presenting as a laryngeal cyst

Cystic lesions of the larynx are most commonly benign. However, we report a case of non-Hodgkin's lymphoma (NHL) of the larynx which presented as a supraglottic cyst. This form of presentation has not been previously described in the medical literature.

Endoscopic CO2 laser surgery for an atypical carcinoid tumor of the epiglottis masquerading as a supraglottic cyst

Atypical carcinoid tumor is a neuroendocrine tumor; its occurrence in the larynx is uncommon, and clinical manifestations are rare. We report an unusual case of atypical carcinoid tumor of the epiglottis mimicking a supraglottic retention cyst. A 44-year-old woman complained of an intermittent globus sensation of the throat of 2 years' duration. A 1.0- x 0.8-cm cystic lesion was found over the tip of the epiglottis. A supraglottic retention cyst was initially diagnosed, and the patient was treated medically. Her symptoms persisted, so we performed a laryngoscopic biopsy, which suggested an atypical carcinoid tumor. Transoral endoscopic CO2 laser surgery and bilateral elective neck dissection were subsequently performed. The 2-year follow-up did not reveal any locoregional recurrence or distant metastasis. This aggressive neoplasm may cause only a few, unremarkable symptoms and masquerade as a supraglottic cyst. Endoscopic CO2 laser surgery can be used to resect this uncommon tumor, with oncologically sound results and without surgical morbidity.

A supraglottic laryngeal cyst causing obstructive sleep apnea syndrome

Objectives: Cysts in the region of the larynx seldom caused clinical significant symptoms. The adult patients with laryngeal cysts complained primarily of hoarseness, dysphagia, and stridor. However, laryngeal cysts may result in obstructive sleep apnea syndrome. Methods: We report a case of a 47-year-old woman who arrived at our hospital with progressive snoring and daytime sleepness for more than 12 months. Meanwhile, she also suffered from excertional dyspnea, intermittent stridor, and foreign body sensation when swallowing. Her body mass index was 29.6 kg/m2. Indirect mirror and fibroscopic examination revealed a huge pedunculate supraglottic cyst that located on the right aryepiglottic fold. A dynamic magnetic resonance image demonstrated a soft tissue mass with a small pedicle attached to the supraglottic laryngeal wall that obliterated the airway. A preoperative polysomnogram showed mild obstructive sleep apnea syndrome (respiratory disturbance index [RDI] = 13.2 events/hour; snoring index [SI] = 82.6 events/hour). A cystic mass, 2.0 × 1.0 × 1.0 cm 3 in size, was removed by endoscopic carbon dioxide laser surgery. Results: The histological diagnosis was an epithelial cyst. After surgery, a polysomogram revealed a moderate improvement (RDI = 6.7 events/hour; SI = 37.9 events/hour) and she completely recovered from daytime somnolence. Conclusion: A supraglottic cyst in an adult rarely causes obstructive sleep apnea syndrome. Microlaryngoscopic laser surgery is effective in the surgical removal of a supraglottic cyst.

Congenital supraglottic cyst: A rare cause of stridor

Congenital laryngeal cysts are very rare and if mismanaged, lead to a high incidence of morbidity and mortality. The case may present as severe stridor and emergent management can obviate a tracheostomy, achieving cure in the process. We report here a case of supraglottic cyst, which was completely occluding the airway and was managed in the emergency setting.

Recrudescence of Opioid Effects After Intraoperative Remifentanil Infusion Complicated by Infiltration of the Intravenous Catheter

To the Editor: We describe a case in which recrudescence of opioid effects occurred shortly after the emergence. A 77-yr-old woman (5[prime]6[prime], 65 kg) underwent microscopic direct laryngoscopy and laser excision of a supraglottic cyst. General anesthesia was induced with a remifentanil infusion of 0.5 [micro sign]g [center dot] kg-1 [center dot] min-1 and a propofol bolus of 1.0 mg/kg; succinylcholine 1.5 mg/kg was given to facilitate laryngoscopy and endotracheal intubation. Anesthesia was maintained with remifentanil, nitrous oxide 70% in oxygen, and isoflurane 0.2%. The remifentanil infusion rate was decreased to 0.25 [micro sign]g [center dot] kg-1 [center dot] min-1 1 min after intubation and to 0.125 [micro sign]g [center dot] kg (-1) [center dot] min-1 10 min thereafter. The succinylcholine infusion was titrated using a nerve stimulator. Thirty minutes into the procedure, the antecubital IV line had infiltrated. Approximately 162.5 [micro sign]g (0.125 [micro sign]g [center dot] kg-1 [center dot] min-1 x 65 kg x 20 min) of remifentanil had been infused. A second IV catheter was promptly inserted, and the succinylcholine and remifentanil infusions were restarted within 6 min. Fifteen minutes later, the succinylcholine infusion was stopped. Five minutes later, the surgery ended, and the nitrous oxide, isoflurane, and remifentanil were discontinued simultaneously. The IV tubing was flushed. Within 10 min, the patient was breathing regularly at a rate of 12 breaths/min; she seemed appropriate, responded to verbal commands, and demonstrated a 5-s head lift. She was tracheally extubated and transported to the recovery room. One minute after her arrival in the postanesthesia care unit, the patient's respiratory rate was 4 breaths/min, her heart rate was 40-45 bpm, and her SpO2 was 88%-92%. She did not respond to a vigorous painful stimulus (jaw thrust). We unsuccessfully attempted to ventilate the patient using a bag-valve-mask apparatus. After the administration of naloxone 40 [micro sign]g IV, her respiratory rate was 12 breaths/min, and her SpO2 improved. A repeat naloxone dose was given, and the patient responded appropriately to verbal stimuli. The patient's subsequent postoperative recovery was uneventful. Why did opioid effects recrudesce in this patient? We postulate that the interstitial remifentanil accumulation provided a sequestered repository from which remifentanil gradually diffused back into the circulation. We caution that remifentanil may have prolonged opioid effects when infused interstitially rather than directly into the circulation. Giovanni Cucchiaro, MD Richard A. Beers, MD Department of Anesthesiology; SUNY Health Science Center; Syracuse, NY 13210

Subglottic Cysts in the Premature Infant

Supraglottic cysts in the newborn are a well-recognized entity, but subglottic cysts have been rarely reported. Over the past 6 years we have observed subglottic cysts in nine patients with relatively long intubations from the neonatal intensive care unit of two university hospitals. Most frequently the patients were extubated and did well for weeks or months, but then they had progressive biphasic stridor. On endoscopy the patients had a subglottic stenosis that was irregular but with a smooth mucosal lining. Usually the cysts were apparent, but in two patients the mucosa was thickened and the patients were treated as a subglottic stenosis with tracheostomy. These subglottic cysts were recognized at the time of laryngotracheoplasty. In six patients the cysts were managed either by marsupialization with cup forceps, endoscopic diathermy, or carbon dioxide laser without recurrence. It is our belief that this condition is most likely due to scarring and obstruction of mucus glands of the subglottic area from prolonged intubation. This entity should be recognized and looked for in the neonate who has an acquired subglottic stenosis and should first be treated conservatively with endoscopic marsupialization.