Laryngeal cysts — Their surgical management

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<jats:title>Abstract</jats:title><jats:p>Congenital cysts of the larynx, recently named lateral saccular cysts by DeSanto, arise in one of three ways. They may be derivatives of the third visceral pouch, developmental abnormalities incurred during canalization of epithelial Primordium of the laryngeal ventricle and saccule, or form from epithelial buds sequestered during saccular development.</jats:p><jats:p>The cysts may become symptomatic at any time from birth to adulthood. The symptoms vary from relatively mild to severe, and consist of vocal changes respiratory distress and deglutatory difficulties. Severe symptoms are usually seen in the infant, and the symptoms in the infant usually become manifest prior to the third or fourth month.</jats:p><jats:p>A majority of reported cases have been post mortem examinations. Modern medical techniques provide early diagnosis and ease of management of this rare but salvageable problem. Endoscopic stripping of the cyst wall in infants appears to be a satisfactory approach with immediate resolution. An external approach to the large, usually scarred cysts of adults is recommended. The lateral thyrotomy approach to the pre‐epiglottic and paraglottic space provides excellent access with minimal long term postoperative laryngeal dysfunction.</jats:p><jats:p>Three representative cases are presented in the body of the paper; a neonate requiring immediate airway, an infant age three months with progressive symptoms, and a young adult vocalist who became symptomatic following an upper respiratory infection and postoperatively was able to continue singing.</jats:p>

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