Overview
Congenital laryngeal cysts are rare benign lesions that can obstruct the airway, particularly in pediatric patients, often arising from remnants of embryonic structures or glandular duct anomalies 2.Diagnosis
Symptoms: Respiratory obstruction, stridor, dyspnea, and nonspecific symptoms 2.
Primary Diagnostic Tool: Laryngoscopy 1.
Additional Imaging: Cross-sectional imaging may be necessary for detailed assessment 1.
Emerging Techniques: Consideration for endolaryngeal ultrasound and optical coherence tomography in future evaluations 1.Management
First-Line Treatment: Endoscopic unroofing or marsupialization for congenital saccular cysts 2.
Surgical Approach: Lateral cervical approach to the thyrohyoid membrane for complete removal, particularly effective in reducing recurrence and need for tracheotomy 2.
Adjunctive Measures: Tracheotomy may be required temporarily in severe cases 2.Special Populations
Pediatrics: Congenital cysts often present early with respiratory distress; endoscopic and surgical interventions are crucial 2.Key Recommendations
Laryngoscopy is essential for initial diagnosis of laryngeal cysts 1.
For congenital saccular cysts, surgical removal via lateral cervical approach is recommended over repeated endoscopic procedures to minimize recurrence and need for tracheotomy (Evidence: Moderate) 2.
Cross-sectional imaging should be considered when endoscopic findings are inconclusive or for preoperative planning 1 (Evidence: Moderate).References
1 Heyes R, Lott DG. Laryngeal Cysts in Adults: Simplifying Classification and Management. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2017. link
2 Ward RF, Jones J, Arnold JA. Surgical management of congenital saccular cysts of the larynx. The Annals of otology, rhinology, and laryngology 1995. link