Acute presentation of an intraoral dermoid cyst causing airway compromise in a young child

Abstract

A 4-month-old boy presented with a cystic swelling at the floor of the mouth causing acute airway compromise. The only previous history of note, was a tongue tie release at 3 days old. CT scan suggested a dermoid cyst with extensive floor of mouth abscess. He had an excision of the cyst and drainage of the superimposed abscess and made a good recovery. The histology report revealed a dermoid cyst which is a rare diagnosis in a child, particularly within the oral cavity. Early treatment is required to remove these lesions especially when they cause airway compromise or swallowing difficulties. This is the first case to our knowledge which suggests tongue tie release procedures causes a predisposition to the development of dermoid cysts in the oral cavity.

Validity of Intraoral surgical approach for enucleation of large plunging sublingual dermoid cysts

“…However, these cysts usually presented with thin walls. The existence of cutaneous adnexa is considered the main histological difference with epidermoid cysts [13][14][15][16] . This finding was consistent with the current study observations.…”

Sublingual dermoid cyst in an infant: A case report and review of the literature

“…2,3 The sublingual dermoid cyst is located in the midline, above, or below the mylohyoid muscle. 4 Dermoid cysts generally present slow and progressive growth, and even if they are congenital, the diagnosis is commonly possible in the second or third decade of life. 5 About 7% of all dermoid cysts found in the body are formed in the head or neck region, and only 1.6% may occur within the oral cavity.…”

“…Dermoid cysts in the head and neck can be associated with displaced epithelium or entrapped epithelial rest during the midline fusion between the first and second branchial arches that happens during the four weeks of development 2,3 . The sublingual dermoid cyst is located in the midline, above, or below the mylohyoid muscle 4 …”