CASE REPORTS   

Chirurgia 2010 February;23(1):21-3

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Neonatal laryngeal saccular cyst: a case report

Varetti C., Giannotti G., Meucci D., Garzi A., Molinaro F., Messina M.

Department of Pediatrics, Obstetrics and Reproductive Medicine, Pediatric Surgery Section, University of Siena, Siena, Italy

Neonatal laryngeal saccular cysts are rare and manifest themselves as diverticulum departing from the laryngeal ventricle and extending to the thyroid cartilage. Male, born at 41+5 week in an eutocic delivery, birth weight 3,550 g, Apgar 6, 8 to 1’ and 10’. Due to respiratory distress the patient was intubated and transferred to the Intensive Care Unit. A chest X-ray showed pneumomediastinum and pneumothorax, which were resolved with pleural drainage. On the second day, a laryngoscopy did not allow for the visualization of the larynx because passage of the instrument was impossible. On the third day, ECT and the NMR showed a left-sided polylobed cystic formation of approximately 25 x 12 mm that required surgery using a cervical lateral approach. The post-operative course was normal with spontaneous breathing on the third day and discharge on the fifteenth. The short and long-term follow-up was normal. The incidence of congenital laryngeal cysts is 1.87:100.000. Their presence can be serious and fatal. Striking symptoms at birth are rare. Our patient presented respiratory distress immediately following birth. The standard diagnostic procedure requires an ECT and a laringoscopy. The CT and NMR remain indispensable in determining the location and extension of the mass. Therapeutic action, endoscopic or traditional, is still controversial. In our case, because of the size of the cysts and clinical conditions, we considered the traditional approach to be appropriate. We believe that early detection and timely surgical treatment are necessary. Lack of complications and the excellent results of the follow-up support the traditional approach which was undertaken.