Vallecular cysts in newborns and young infants

Vallecular cyst is a rare cause of stridor and respiratory distress in infa ncy and has been associated with sudden airway obstruction resulting in dea th. In a retrospective review of eight cases over a 20-year period all infa nts developed symptoms during the first week of life. All had strider and f eeding difficulties and two required endotracheal intubation. Other common findings included signs of increased work of breathing and episodes of cyan osis. Failure to thrive was present in five patients diagnosed later than t he first week of life. An abnormal or a hoarse cry was present in only two patients. Diagnosis in all cases was made by endoscopy. Where a VC is clini cally suspected, it is important to stress the need to visualize the base o f the tongue during any diagnostic endoscopic procedure. At endoscopy, a sm ooth localized mass arising from and distorting the lingual surface of the epiglottis was identified. Histologically, the cysts contained respiratory epithelium with mucous glands with an external lining of squamous epitheliu m. Treatment by cyst marsupialization is safe and definitive, in particular when performed by CO2 laser. (C) 1999 Wiley-Liss, Inc.