A Case of Extra-Laryngeal Resection of a Thyroid-Cartilage Foraminal Cyst

Abstract

A thyroid-cartilage foraminal cyst is uncommon among the rare congenital laryngeal cysts, and common manifests stridor and dyspnea. We present a patient with a thyroid-cartilage foraminal cyst resected according to the extra-laryngeal approach, and discuss the literature.
A 7-day-old infant boy with severe stridor was referred to the pediatrics department. On admission, respiratory care via directional positive airway pressure was commenced; however, the stridor worsened. He was then referred to our department for assessment of his upper respiratory tract. Flexible fiberoptic laryngoscopy revealed a submucosal swelling of the left laryngeal ventricle to the arytenoid and a stenosis in the glottis gap. Based on computed tomography findings of a cystic lesion, a congenital larynx cyst was suspected. Cyanosis occurred at 21 days of age, and endoscopic fenestration was undertaken twice, but was ineffective. We performed the extra-laryngeal resection method and laryngofissure approach, and excised the cyst. After the last operation, the stridor improved, but a slight hoarseness remained. There has been no recurrence for 18 months following surgery.
In this case, cyst resection by the extra-laryngeal approach was useful when the endoscopic transoral approach was ineffective. Physicians should consider resection according to the extra-laryngeal approach in patients with suspected congenital larynx cyst in which the endolaryngeal approach is unsuccessful.