Symptomatic vallecular cysts: diagnosis and management with the KTP laser

Abstract

The objective of this study is to discuss the evaluation and treatment of patients with vallecular cysts removed via potassium titanyl phosphate (KTP) laser therapy. This is a retrospective cohort study with longitundinal follow-up. Clinical records were reviewed for demographic information, symptoms, and findings on laryngoscopy of nine patients having had KTP laser surgery for vallecular cysts. Nine patients (six female, three male) had vallecular cysts removed via KTP laser. The average age at the time of removal was 61, with a range of 34–95 years. The most common preoperative symptom was dysphagia, present in two-thirds of patients. The most common physical exam finding was a smooth, rounded vallecular cyst with reproduction of symptoms upon palpation of the lesion. More than half of the patients had a history of laryngopharyngeal reflux disease and were being treated with acid-reducing medication. Only, patient #1 had a history of trauma. All but two patients had a vallecular cyst located on the right side. Four of the patients underwent treatment in the office procedure room and five in the operating room. The average age of those treated in the office was 71 and 53 in the operating room. 89 % of patients had complete resolution of symptoms post operatively. Patient #4, treated in the office, continued to experience the symptoms but was lost to follow-up. No complications or adverse events were noted. KTP laser removal of vallecular cysts is a successful treatment option for symptomatic patients. Furthermore, the ability to remove such lesions in an office setting is advantageous, cost-effective, and convenient.

Level of evidence: Level 4.