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

Korean Journal of Pediatrics 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 Yang1, Min Jae Kang1, Jeana Hong1, Seung Han Shin1, Sang Duk Kim1, Ee-Kyung Kim1, Han-Suk Kim1, Jung-Hwan Choi1, Tack Kyun Kwon2, In-One 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
협착음과 수유시 청색증 및 성장 장애를 보인선천성 후두개 낭종(vallecular cyst) 1예
양미애1, 강민재1, 홍지나1, 신승한1, 김상덕1, 김이경1, 김한석1, 최중환1, 권택균2, 김인원3
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 이비인후과학교실
3서울대학교 의과대학 영상의학과학교실
Correspondence: 
Jung-Hwan 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.
Key Words: Vallecular cyst, Gastroesophageal reflux, Failure to thrive, Feeding cyanosis, Inspiratory stridor, Marsupialization


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