Acquired paediatric subglottic cysts: a series from Manchester.
Subglottic cysts (SGC) have long been regarded as a rare cause of airway obstruction but through increased awareness an increase in the number of cases of SGC has been reported.


OBJECTIVE
This paper describes the pathogenesis and management of SGC.


METHODS
Retrospective case series. Ethical approval not sought.


METHODS
Royal Manchester Children's Hospital.


METHODS
Two hundred and six new referrals for direct laryngotracheobronchoscopy (DLTB) were identified from records between September 2003 and September 2005.


METHODS
Age at birth, sex, length of intubation, presenting symptoms, age at presentation, DLTB findings, interventional procedures, and follow-up DLTBs.


RESULTS
Fourteen out of 206 (6.8%) infants were diagnosed as with subglottic cysts. This represented the fourth most common cause of upper airway pathology. Thirteen out of 14 (93%) infants were preterm (26.8 weeks S.D. 25.3-28.3 weeks). All infants had been intubated ranging from 1 to 180 days (median 42 days). The onset of symptoms ranged from 1 to 13 months (median 4.25 months). Initially, 8/14 (57.2%) infants had SGC cysts marsupialised with microforceps. A further six cysts (50%) were decapped between 2 and 4 months and one between 6 and 12 months.


CONCLUSIONS
The number of cases of SGC has been increasing over the last three decades and represents the fourth most common causes of airway obstruction in our series. There is a delay in onset of symptoms and high rate of recurrence in the first 4 months. It is therefore prudent to reschedule further endoscopic evaluation between 2 and 4 months and after 6 months should the clinical need arise.
Watson
Glen J
GJ
University Department of Otolaryngology Head and Neck Surgery, Hope Hospital, United Kingdom. glen_watson74@yahoo.co.uk
Malik
Tass H
TH
Khan
Naveed A
NA
Sheehan
Patrick Z
PZ
Rothera
Michael P
MP
D001999:Bronchoscopy; D003560:Cysts / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005931:Glottis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D007442:Intubation, Intratracheal; D007818:Laryngeal Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D007828:Laryngoscopy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom