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Minimally invasive procedure for diagnosis and treatment of vallecular cysts in children: review of 156 cases

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Vallecular cyst is an uncommon but potentially life-threatening disease. The aim of this study was to review the presentation, evaluation, and treatment of vallecular cysts in children.

Methods

Medical records of 156 patients treated for vallecular cysts between 2013 and 2016 were retrospectively reviewed. The patients were divided into four age groups for comparison of clinical data: A, < 1 month; B, 1–6 months; C, 7–12 months; and D, > 1 year.

Results

The median age of all patients (98 males and 58 females) was 12.1 months (range 1 day–11 years), including 21, 86, 21, and 28 patients in group A, B, C, and D, respectively. A diagnosis of vallecular cysts was made for 135 patients using a combination of flexible laryngoscopy and ultrasound, and ten patients (all in group A) required pre-surgery ventilation support. The most common symptoms were wheezing (59.6%) and stridor (36.5%). Ten patients experienced difficulty with intubation. Endoscopic-assisted transoral coblation marsupialization was performed for all patients, combined with supraglottoplasty for 41 out of 68 patients with concurrent laryngomalacia. Patients in group D had a longer operation time and higher incidence of intraoperative bleeding, two of whom experienced post-operation recurrence, and symptoms resolved after a second operation in both cases.

Conclusions

Flexible laryngoscopy and ultrasound are recommended for a diagnosis in suspected cases of vallecular cysts. Coblation marsupialization has advantages of minor damage, low recurrence rate, and suitability for all age groups.

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Acknowledgements

We thank Dr. Xiao-man Wang from Department of Ultrasound, Beijing Children’s Hospital, for her help with collection and analysis of the imaging data.

Funding

This study was supported by Beijing Hospitals Authority Ascent Plan (20191201).

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Authors and Affiliations

  1. Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health (NCCH), Beijing, 100045, China

    Gui-xiang Wang, Feng-zhen Zhang, Jing Zhao, Hua Wang, Hong-bin Li, Jie Zhang & Xin Ni

  2. Department of Ultrasound, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health (NCCH), Beijing, 100045, China

    Xiao-man Wang

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  1. Gui-xiang Wang
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  2. Feng-zhen Zhang
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  4. Hua Wang
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  5. Hong-bin Li
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  6. Xiao-man Wang
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  7. Jie Zhang
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  8. Xin Ni
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Correspondence to Jie Zhang or Xin Ni.

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Wang, Gx., Zhang, Fz., Zhao, J. et al. Minimally invasive procedure for diagnosis and treatment of vallecular cysts in children: review of 156 cases. Eur Arch Otorhinolaryngol 277, 3407–3414 (2020). https://doi.org/10.1007/s00405-020-06163-9

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  • DOI: https://doi.org/10.1007/s00405-020-06163-9

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