Vallecular Cyst: Reminder of a Rare Cause of Stridor and Failure to Thrive in Infants

Abstract

The vallecular cyst is a rare cause of stridor, respiratory distress, and failure to thrive in infants. Large vallecular cysts may present with serious complications such as life-threatening airway obstruction. This report is of an infant who presented with stridor and failure to thrive. The patient’s condition was diagnosed as the presence of a vallecular cyst using flexible laryngoscopy. The vallecular cyst was successfully managed using endoscopic marsupialization. After the procedure, the patient was asymptomatic and dramatically gained weight within a few months. This case report serves as a reminder for clinicians to consider vallecular cysts as a differential diagnosis of stridor and failure to thrive in infants. It also emphasizes that early diagnosis and management lead to favorable clinical outcomes.

Successful excision of a large congenital vallecular cyst in a female newborn: A case report

“…Vallecular cysts (VC) are an infrequent type of laryngeal cysts, accounting for 10.5–20.1% of all congenital laryngeal cysts, with an estimated incidence rate of about 3.49–5.3 per 100,000 newborn cases. These cysts arise from either the lingual surface of the epiglottis, as in our case, or the base of the tongue [ 2 ]. They are an uncommon but recognized cause of stridor and upper airway obstruction, making them a life-threatening condition that requires crucial management to avoid any potential complications [ 2 , 3 , 5 , 6 , 8 ].…”

“…These cysts arise from either the lingual surface of the epiglottis, as in our case, or the base of the tongue [ 2 ]. They are an uncommon but recognized cause of stridor and upper airway obstruction, making them a life-threatening condition that requires crucial management to avoid any potential complications [ 2 , 3 , 5 , 6 , 8 ].…”

“…The most serious clinical feature of this condition is supraglottic respiratory tract obstructions, which can cause several symptoms such as inspiratory stridor, poor feeding, choking while eating or drinking, respiratory distress, and failure to thrive [ [2] , [3] , [4] , [5] , 9 ]. Larger cysts can increase the risk of life-threatening airway obstruction, particularly in infants due to the small size of their respiratory tract [ [2] , [3] , [4] , [5] ]. Infants typically present within the first weeks after birth with congenital stridor and poor feeding [ 5 , 8 , 9 ].…”

“…vallecular cysts (VC) are a rare cause of stridor in infants, with an incidence of 3.49–5.3 cases per 100,000 newborns [ 1 , 2 ]. vallecular cysts are uncommon in infants, representing 10.5–20.1% of all congenital laryngeal cysts [ 2 , 3 ]. The vallecular cyst is a unilocular cystic mass and its content is clear and non-infected fluid [ 4 ].…”

“…The most common symptom in infants is congenital stridor [ 5 ]. While a small laryngeal cyst may remain asymptomatic, larger ones may present serious complications, such as life-threatening airway obstruction, poor feeding, and failure to thrive [ 2 , 6 ]. Nasopharyngolaryngoscopy is needed to confirm the diagnosis and determine the extension of the cyst.…”