title: Subglottic cysts: the Great Ormond Street experience.
abstract: OBJECTIVE
  Subglottic cysts are a relatively rare, non-malignant cause of airway obstruction. In this study we reviewed the details of the patients who were treated for subglottic cysts in our department in order to evaluate the presentation and treatment of patients with this condition.
  
  
  METHODS
  We performed a retrospective case note analysis of 55 patients with subglottic cysts. Case notes were examined to determine the following details for each patient: date of birth, gestational age at birth, history and length of intubation, age at presentation, presenting symptoms, findings on endoscopy, treatment given for subglottic cysts, recurrence(s) of cysts after initial treatment, and follow up for a minimum of 6 months post diagnosis.
  
  
  RESULTS
  Fifty five patients were identified, 35 male, 20 female. Ninety four percent were born prematurely at 24-31 weeks gestation. All patients were intubated in the neonatal period. The median duration of intubation for all patients was 10 days (range 1-126). Fifty one patients underwent intervention for their subglottic cysts at their initial, diagnostic microlaryngoscopy and bronchoscopy (MLB), and recurrent cysts occurred in 22 cases. A total of 82 procedures for cyst removal were performed, using either the carbon dioxide laser or microinstruments. Subglottic stenosis was a commonly associated feature in our series of patients, being present in 38 patients. Eleven of the 14 patients who presented to our department with tracheostomies in situ were decannulated after removal of their subglottic cysts.
  
  
  CONCLUSIONS
  This review of the largest series of patients with subglottic cysts reported to date, reinforces our view that such cysts are rare but potentially reversible causes of upper airway obstruction, and that they result from injury to the larynx as a result of endotracheal intubation. Treatment of the cysts will often be sufficient to correct the obstructed airway allowing successful extubation or decannulation of a tracheostomy. Patients who have had subglottic cysts treated should have access to long-term follow up as there is a tendency for these cysts to recur.
authors.affiliation: Department of Otolaryngology, Great Ormond Street Hospital for Sick Children, London WC1N 3JH, UK. jeromelim@doctors.org.uk
authors.forename: Jerome
authors.initials: J
authors.lastname: Lim
authors.forename: William
authors.initials: W
authors.lastname: Hellier
authors.forename: Jonathan
authors.initials: J
authors.lastname: Harcourt
authors.forename: Susanna
authors.initials: S
authors.lastname: Leighton
authors.forename: David
authors.initials: D
authors.lastname: Albert
mesh_terms: D001999:Bronchoscopy; D002245:Carbon Dioxide; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005931:Glottis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal; D007818:Laryngeal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000150:complications*; D053685:Laser Therapy / Q000379:methods; D008297:Male; D012008:Recurrence; D012135:Respiratory Sounds / Q000209:etiology; D012189:Retrospective Studies; D014139:Tracheostomy; D006113:United Kingdom
chemical_list: D002245:Carbon Dioxide