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Treatment of vallecular cysts in infants with and without coexisting laryngomalacia using endoscopic laser marsupialization: Fifteen-year experience at a single-center.
MedLine Citation:
PMID:  23280279     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To share our experience in treating a large cohort of infants with congenital vallecular cysts using endoscopic laser marsupialization. We describe the clinical characteristics of infants with pediatric vallecular cysts and compare these characteristics between infants with and without concurrent laryngomalacia and those who did or did not require preoperative airway support. METHODS: Medical records of infants treated for vallecular cyst at Chang Gung Memorial Hospital between March 1994 and July 2008 were reviewed. Demographic and clinical characteristics and outcomes were recorded and compared. RESULTS: Twenty-eight infants were included in our study: 11 (39.3%) males and 17 (60.7%) females. The incidence of vallecular cyst was 5.3 cases/100,000 live births. Median ages at symptom onset and diagnosis were 3.0 and 40.0 days, respectively. Mean symptom onset to diagnosis interval was 42.4 days. Eighteen (64.3%) infants had coexisting laryngomalacia and 11 (39.3%) required ventilatory support. The number of symptoms decreased in all patients after surgery (median no. symptoms before=4.5, after=0.5) and most symptoms were completely resolved within 3 months of surgery. Compared with infants who did not have laryngomalacia, infants with laryngomalacia: were younger at symptom onset (2 vs 10 days); had more symptoms before (5.0 vs 3.5) and after treatment (1.0 vs 0.0); had a longer length of hospital (14.6 vs 9.4 days) stay; and more commonly required airway intervention compared with infants without laryngomalacia (55.6% vs 10.0%: all P<0.05). Compared with infants who did not require ventilatory support, those that did: had a shorter interval between symptom onset and diagnosis (31.8 vs 49.3 days); were younger at the age of diagnosis (38.0 vs 49.0 days); had more symptoms before surgery (5.0 vs 4.0); had a higher prevalence of laryngomalacia (90.9% vs 47.1%); had a longer length of hospital (16.4 vs 10.4 days) stay (all P<0.05). CONCLUSIONS: Our study included a large number of infants with vallecular cyst who were treated with endoscopic laser marsupialization. Of note, we found that a large proportion of infants had coexisting laryngomalacia, which appears to complicate the clinical presentation and management of vallecular cyst.
Authors:
Yao-Te Tsai; Li-Ang Lee; Tuan-Jen Fang; Hsueh-Yu Li
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-29
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  -     ISSN:  1872-8464     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-1-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
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