title: Evaluation of pediatric subglottic cysts.
abstract: BACKGROUND
  Subglottic cysts (SGCs) are increasingly recognized as a cause of upper airway obstruction in previously intubated infants. Endoscopic marsupialization with cold steel instruments or CO(2) laser has been reported to be the standardised treatment method for SGCs. SGC case series of 9 patients who were treated with endoscopic marsupialization with cold steel instruments or CO(2) laser and mechanical decompression with balloon dilatation are presented.
  
  
  METHODS
  Retrospective study of 9 cases of subglottic cysts treated between 2003 and 2010 was done. Diagnoses were made by performing flexible nasopharyngolaryngoscopy and surgical treatment was done through endoscopic marsupialization with cold steel instruments or CO(2) laser.
  
  
  RESULTS
  The age range of SGC patients were between 3 months and 36 months (average 12, 11 months). Two of the patients were female (2/9), 7 of them were male (7/9). SGC diagnoses were made by flexible nasopharyngolaryngoscopy. History of intubation was noted in 3 of the patients (3/9). Duration of intubation was 28 days, 6 days, and 8 days respectively. Cysts were multiple in all cases, and located posteriorly and laterally at the subglottic area and upper trachea. The patients presented with were stridor, fail to thrive, and recurrent croup attacks. Treatment methods preferred for these patients were endoscopic marsupialization with cold steel instruments or CO(2) laser and mechanical decompression with balloon dilatation. The follow-up period after treatment ranged between 8 months and 3 years. Recurrence of the SGCs did not happen and re-evaluation under general anesthesia was reserved for the symptomatic patients.
  
  
  CONCLUSIONS
  Diagnostic laryngoscopy and bronchoscopy are important in diagnosing SGC. History of premature birth and intubation are not 'sine qua non' of SGC as SGC may be congenital as well. Symptoms of SGCs may mimic the characteristic features of chronic obstructive lung disease, so evaluation of the airway should be considered in such infants if they have stridor or hoarseness not responding to routine treatment. Laryngoscopy and bronchoscopy are routinely indicated for airway evaluation in at-risk infants.
authors.affiliation: Acibadem University School of Medicine, Otorhinolaryngology Head & Neck Surgery Department, Istanbul, Turkey. elifayanoglu@yahoo.com
authors.forename: Elif Ayanoglu
authors.initials: EA
authors.lastname: Aksoy
authors.forename: Cagdas
authors.initials: C
authors.lastname: Elsürer
authors.forename: Gediz Murat
authors.initials: GM
authors.lastname: Serin
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Unal
mesh_terms: D001999:Bronchoscopy / Q000379:methods; D002404:Catheterization / Q000379:methods; D002675:Child, Preschool; D003560:Cysts / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D007828:Laryngoscopy / Q000379:methods; D007829:Laryngostenosis / Q000175:diagnosis / Q000209:etiology; D053685:Laser Therapy / Q000379:methods; D008297:Male; D010608:Pharyngeal Diseases / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome