Emergency Airway Obstruction in Newborn Due to Congenital Saccular Cyst

Itzhak Braverman, Galit Avior, Michael Feldman, Andrei Gubarev, Ronnie Stein, Hakeem Abu Ras, Abdel-Rauf Zeina

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Department of Anesthesiology, The Hillel Yaffe Medical Center, Hadera, Israel.
Newborn and Neonatal Care Department, The Hillel Yaffe Medical Center, Hadera, Israel.
Otolaryngology—Head and Neck Surgery Unit, The Hillel Yaffe Medical Center, Hadera, Israel.

DOI: 10.4236/ijohns.2013.21009                

Abstract

Laryngeal cyst causing neonatal airway obstruction during labor is a very rare condition [1]. Congenital laryngeal cysts are a rare cause of neonatal airway obstruction. Traditionally, these cysts have been treated surgically by endoscopic excision or marsupialization. However, the cyst often extends beyond the larynx. We describe a case of a newborn that, during delivery, became cyanotic due to airway obstruction and respiratory distress. To the best of our knowledge this is the first report of a saccular cyst obstructing airway during birth prior to intubation. The immediate and late treatments together with a literature review are described.

Keywords

Sacullar Cyst; Airway Obstruction; Obstructive Sleep Apnea; Congenital Laryngeal Cysts

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	V. Forte, G. Fuoco and A. James, “A New Classification System for Congenital Laryngeal Cysts,” Laryngoscope, Vol. 114, No. 6, 2004, pp. 1123-1127. doi:10.1097/00005537-200406000-00031
[2]	A. L. Abramson and B. Zielinski, “Congenital Saccular Cysts of the Newborn,” Laryngoscope, Vol. 94, No. 12, 1984, pp. 1580-1581. doi:10.1288/00005537-198412000-00009
[3]	P. H. Holinger, L. D. Holinger, D. R. Barnes and L. J. Smid, “Laryngocele and Saccular Cysts,” Annals of Otology, Vol. 87, No. 5, 1978, pp. 675-685.
[4]	L. W. Desanto, K. D. Devine, L. H. Weiland, “Cysts of the Larynx, Classification,” Laryngoscope, Vol. 80, No. 1, 1970, pp. 261-267. doi:10.1288/00005537-197001000-00013
[5]	C. Arens, H. Glanz and O. Kleinsasser, “Clinical and Morphological Aspects of Laryngeal Cysts,” European Archives of Oto-Rhino-Laryngology, Vol. 254, No. 9-10, 1997, pp. 430-436. doi:10.1007/BF02439974
[6]	S. M. Ahmad and A. M. Soliman, “Congenital Anomalies of the Larynx,” Otolaryngologic Clinics of North America, Vol. 40, No. 1, 2007, pp. 177-191. doi:10.1016/j.otc.2006.10.004
[7]	D. J. Kirse, C. J. Rees, A. W. Celmer, D. E. Bruegger, “Endoscopic Extended Ventriculotomy for Congenital Saccular Cysts of the Larynx in Infants,” Archives of Otolaryngology—Head & Neck Surgery, Vol. 132, No. 7, 2006, pp. 724-728. doi:10.1001/archotol.132.7.724
[8]	C. A. Righini, H. Kadaoui, N. Morel, C. Llerena, E. Reyt, “Stridor in a Newborn Caused by a Congenital Laryngeal Saccular Cyst,” International Journal of Pediatric Otorhinolaryngology Extra, Vol. 1, No. 2, 2006, pp. 145-149. doi:10.1016/j.pedex.2006.03.005
[9]	I. Khodaei, A. Karkanevatos, A. Poulios and M. S. McCormick, “Airway Obstruction in a Newborn Due to a Congenital Laryngeal Cyst,” International Journal of Pediatric Otorhinolaryngology Extra, Vol. 2, No. 4, 2007, pp. 254-256. doi:10.1016/j.pedex.2007.08.001
[10]	E. Ostfeld, Z. Hazan, S. Rabinson and L. Auslander, “Surgical Management of Congen Ital Supraglottic Lateral Saccular Cyst,” International Journal of Pediatric Otorhinolaryngology, Vol. 19, No. 3, 1990, pp. 289-294. doi:10.1016/0165-5876(90)90010-O
[11]	Z. Hazan, E. Ostfeld, S. Rabinson and L. Auslander, “Neonatal Respiratory Distress Due to Congenital Laryngeal Cyst,” Harefuah, Vol. 119, No. 11, 1990, pp. 371-372.
[12]	F. Tosun, H. S?ken and Y. Ozkaptan, “Saccular Cyst in an Infant, an Unusual Cause of Life-Threatening Stridor and Its Surgical Treatment,” The Turkish Journal of Pediatrics, Vol. 48, No. 2, 2006, pp. 178-80.
[13]	R. J. Pennings, F. J. van den Hoogen and H. A. Marres, “Giant Laryngoceles, a Cause of Upper Airway Obstruction,” European Archives of Oto-Rhino-Laryngology, Vol. 258, No. 3, 2001, pp. 137-140. doi:10.1007/s004050100316
[14]	H. M. Danish, R. J. Meleca, J. P. Dworkin and T. R. Abbarah, “Laryngeal Obstructing Saccular Cysts, a Review of This Disease and Treatment Approach Emphasizing Complete Endoscopic Carbon Dioxide Laser Excision,” Archives of Otolaryngology—Head & Neck Surgery, Vol. 124, No. 5, 1998, pp. 593-6.
[15]	E. Silingardi, N. Sola, A. L. Santunione and N. Trani, “Lateral Saccular Laryngeal Cyst and Unexpected Asphyxial Death,” Forensic Science International, Vol. 206, No. 1-3, 2011, pp. e17-e19.
[16]	T. K. Kastowsky, M. P. Stevenson and J. A. Dufou, “Sudden Death from Saccular Laryngeal Cyst,” Journal of Forensic Sciences, Vol. 51, No. 5, 2006, pp. 1144-1146. doi:10.1007/s004050100316
[17]	V. Forte, J. Warshawski, P. Thorner and S. Conley, “Unusual Laryngeal Cysts in the Newborn,” International Journal of Pediatric Otorhinolaryngology, Vol. 37, No. 3, 1996, pp. 261-267. doi:10.1016/0165-5876(96)01407-3
[18]	M. H. Thabet and H. Kotob, “Lateral Saccular Cysts of the Larynx. Aetiology, Diagnosis and Management,” The Journal of Laryngology & Otology, Vol. 115, No. 4, 2001, pp. 293-297. doi:10.1258/0022215011907488