Surgical approach to congenital vallecular cyst with concomitant laryngomalacia
How to cite this article: Kurup B, Sarmah U, Prabhat D, Pereira C. Surgical approach to congenital vallecular cyst with concomitant laryngomalacia. Wadia J Women Child Health 2023;2(2):106-7.
A 10-day-old girl, brought with stridor, feeding difficulties, and persistent cough, tachypnea along with suprasternal and subcostal retractions. Airway assessment revealed a left vallecular cyst pressing on the lingual surface of the epiglottis leading to Type 3 laryngomalacia (posteriorly displaced floppy epiglottis) in addition to bilateral short ary-epiglottic folds (Type 2 Laryngomalacia), further narrowing the upper airway [Figure 1a]. The vallecular cyst was marsupialised with cauterization of the base [Figure 1b]. The short aryepiglottic folds were cut on both sides using microlaryngoscopy scissors and epiglottopexy was performed using 16G needles and 2-0 prolene sutures that were buried beneath the anterior neck skin crease above the level of thyroid cartilage to further widen the supraglottic airway [Figure 1a-d]. The baby recovered well and was completely weaned off oxygen by the 4th postoperative day. Vallecular cyst is a rare cause of neonatal airway obstruction (1.87–3.49 cases per 100,000 live births). In addition to cyst marsupialization, supraglottoplasty with epiglottopexy is the mainstay of treatment of vallecular cyst with concomitant severe type 3 laryngomalacia.
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