TREATMENT OF CONGENITAL LARYNGEAL CYSTS IN NEWBORNS

Abstract

Congenital laryngeal cysts are rare lesions that may occur in newborns, characterized by symptoms of respiratory obstruction and severe dyspnea. The aim of this study was to indicate optimal surgical treatment of congenital laryngeal cysts in newborns. We present a case series of five neonates treated for congenital laryngeal cysts during the 2011-2017 period at our pediatric tertiary care hospital. Patient age ranged from one day to 14 days. All patients had unilateral cysts. After surgical excision, burning of the walls of the cysts was performed by a CO2 laser. In one case, after four months, a recurrent cyst appeared, and re-operation was performed. Our relatively small case series indicates that symptoms such as stridor and labored breathing can occur already during the first days of life and potentially endanger the patient's life. Complete excision of the cyst and burning of its walls with CO2 laser leads to complete cure and prevent recurrence of the lesion.

Keywords: Cyst, congenital; Endoscopy; Larynx; Newborns.

Fig. 1

(a) Endoscopic view of the congenital laryngeal cyst before surgery. Note the presence of laryngeal cyst (asterisk inside) on the right ventricular fold; (b) coronal plane of the computed tomography scan of the throat. Note the presence of a laryngeal cyst on the right lateral wall of the larynx (arrow head); (c) endoscopic view, 7 days after excision of the cyst from the right ventricular fold. Note the presence of two breaches on the inner surface of the larynx; (d) endoscopic view in the same patient 12 months after surgical treatment. Note the absence of breaches.

Fig. 2

Photomicrograph of an excised congenital laryngeal saccular cyst of the ventricular fold. The inner surface of the cyst is lined by pseudostratified respiratory epithelium (arrow head). Note the presence of seromucinous glands (asterisk) (hematoxylin-eosin staining, magnification X50).