All issues > Volume 51(7); 2008

Case Report

Korean J Pediatr. 2008;51(7):775-779. Published online July 15, 2008.

A case of congenital vallecular cyst associated with gastroesophageal reflux presenting with stridor, feeding cyanosis, and failure to thrive

Mi Ae MA Yang¹, Min Jae MJ Kang¹, Jeana JN Hong¹, Seung Han SH Shin¹, Sang Duk SD Kim¹, Ee-Kyung EK Kim¹, Han-Suk HS Kim¹, Jung-Hwan JH Choi¹, Tack Kyun TK Kwon², In-One IO Kim³

¹Departments of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
²Departments of Otorhinolaryngology, Seoul National University, College of Medicine, Seoul, Korea
³Departments of Radiology, Seoul National University, College of Medicine, Seoul, Korea

Correspondence Jung-Hwan JH Choi ,Email: neona@plaza.snu.ac.kr

Abstract

Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a CO2 laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with CO2 laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

Keywords :Vallecular cyst, Gastroesophageal reflux, Failure to thrive, Feeding cyanosis, Inspiratory stridor, Marsupialization