Vallecular Cyst and Laryngomalacia in Infants: Report of Six Cases and Airway Management

Abstract

This report describes difficulties encountered in the airway management of six infants with concurrent vallecular cyst and laryngomalacia. It is hoped that our experience will assist others in the management of such patients.

A Vallecular Thyroglossal Duct Cyst Presenting with Persistent Unexplained Cough in a Toddler

“…Vallecular masses, in general, have been associated with laryngomalacia [4,7] but that was not encountered in our case. When large enough, they can also displace the epiglottis and obscure the airway [4], and thus require extra care during intubation.…”

“…When large enough, they can also displace the epiglottis and obscure the airway [4], and thus require extra care during intubation. Possible intraoperative complications include cyst rupture and possible aspiration pneumonia, edema, and bleeding [4]. Although our cyst leaked during excision, this did not compromise the dissection nor resulted in aspiration.…”

“…Clinical presentation is variable and they may be asymptomatic mass, or may present with inspiratory stridor, failure to thrive, poor feeding, cyanotic spells, recurrent cough, abnormal hoarse cry, regurgitation of feeds, dyspnea, supralaryngeal obstruction and sudden infant death [2,3]. The mechanical effect on breathing of an infant can be explained by the inferior-posterior displacement of the epiglottis caused by the enlarging mass, or by mass effect on the hypopharynx [4]. This effect is more profound in the neonates who have a relatively smaller airway volume that makes it more prone to collapse [5], resulting in stridor [6,7] or apnea [5].…”

Airway Management in a Pediatric Patient with Glottic Mass

“…Bu tabloyla gelen her hastada kas gevşetici ajan uygulandıktan sonra maske ventilasyonunun ve/veya entübasyonun zor olabileceği unutulmamalıdır. Zor entübasyon olasılığına karşı acil trakeostomi seti hazır bulundurulmalıdır (15) . Biz bu nedenle önce hastamızı entübe edip sonra kas gevşetici ilacımızı yaptık.…”

Quiste congénito de la valécula con alteraciones del peso. Caso clínico

“…Los síntomas dependen del tamaño y la localización del quiste y comprenden estridor, dificultad respiratoria, tos, disfonía, cianosis y episodios aparentemente letales. [1][2][3]7,10 La falla de crecimiento, definida como la incapacidad para sostener una velocidad de crecimiento normal, tanto en peso como en talla, en niños menores de 3 años, no suele ser una presentación habitual. [11][12][13] Otras formas de presentación documentadas en estudios previos incluyen tos crónica, episodios de cianosis repetitivos, cambios en la voz y pobre ingesta alimentaria con escasa ganancia ponderal.…”