title: Diagnosis and treatment of pediatric vallecular cysts and pseudocysts.
abstract: OBJECTIVE
  To review the experience at a children's hospital diagnosing and treating vallecular cysts.
  
  
  OBJECTIVE
  To determine if cyst type, operative mode, or ages are risk factor(s) for recurrence.
  
  
  METHODS
  Chart review of eleven children with vallecular cysts and pseudocysts from 1997 to 2009.
  
  
  RESULTS
  The most common presenting symptoms were stridor (8/12, 67%), respiratory distress (7/12, 58%), and feeding difficulties (4/12, 33%). Symptoms of gastroesophageal reflux disease were present in 67% of patients and 17% carried a concurrent diagnosis of laryngomalacia. Eleven of twelve patients required operative intervention, the majority of which were transoral endoscopic procedures. Three patients (3/11, 27%) had recurrences. Two of these patients required only a second procedure, but one patient required multiple procedures. Fifty percent (2/4) of the patients 2 years or older experienced a recurrence, whereas only 14% (1/7) of the patients less than 2 years old had a recurrence, a difference which was not statistically significant (p=0.49). Pseudocysts tended to recur more frequently than vallecular cysts. (p=0.13). Surgical approach (marsupialization versus total excision) did not affect recurrence rate. One patient with a small, asymptomatic cyst was observed and continues to be symptom-free. There were no surgical complications.
  
  
  CONCLUSIONS
  Vallecular cysts and pseudocysts are rare congenital lesions of the upper aerodigestive tract. Vallecular pseudocysts tended to recur more than vallecular cysts in our series. Surgery is the treatment of choice for symptomatic patients; smaller cysts may be followed closely.
authors.affiliation: Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania School of Medicine, Miami, FL, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Leibowitz
authors.forename: Lee P
authors.initials: LP
authors.lastname: Smith
authors.forename: Marc A
authors.initials: MA
authors.lastname: Cohen
authors.forename: Brian P
authors.initials: BP
authors.lastname: Dunham
authors.forename: Marta
authors.initials: M
authors.lastname: Guttenberg
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Elden
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000151:congenital / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000151:congenital / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence