Introduction

Vallecular cyst is an uncommon but well-recognized cause of upper airway obstruction in newborns and infants.¹Stridor with or without respiratory distress is the most common presentation secondary to narrowing of the upper airway.² Although benign in nature, it may cause severe airway obstruction and even death thus poses an anaesthetic challenge, especially when pediatric airway is already a challenging task.³

Case report

A 2 months old male infant weighing 4 kg, presented with stridor, recurrent pneumonia, noisy breathing and regurgitation since birth. Contrast enhanced CT showed a mass of size 1.7x1.5x1.4 cm at base of the tonge. (Figure 1) It was compressing the laryngeal pathway against oropharyngeal region. (Figure 2) A diagnosis of vallecular cyst was made and patient was planned for decompression and marsupialization of the cyst under general anaesthesia.

1. Gutierrez JP, Berkowitz RG, Robertson CF. Vallecular cysts in newborns and infants. Pediatr Pulmonol 1999;27:282-5.
2. Liu HC, Lee KS, Hsu CH, Hung HY. Neonatal vallecular cyst: Report of eleven cases. Changgeng Yi Xue Za Zhi 1999; 22: 615- 20.
3. Ku AS. Vallecular cyst: Report of four cases — One with co-existing laryngomalacia. J Laryngol Otol 2000;114:224-6
4. Cheng KS, Li HU, Hartigan PM. Vallecular cyst and laryngomalacia in infants: Report of six cases and airway management. Anesth Analg 2002;95:1248-50.
5. Kalra S, Saraswat N, Kaur R, Agarwal RA. Vallecular cyst in a newborn: A challenging airway management. Anaesth Intensive Care 2011;3:509-10.
6. Gandhi S, Raza SA, Thedekar P, Mishra P. Congenital vallecular cyst with laryngomalacia: A report of two cases. J Laryngol Voice 2011;1:27-9.
7. Batra UB, Kale S, Malik A. Anaesthetic management of an infant with vallecular cyst: A challenging situation. Indian J Anaesth 2012;56:423-5.
8. Choi YW, Chon JY, Moon HS, Kim JY, Lee JY. Anesthetic management of a neonate with congenital laryngeal cyst. Korean J Anesthesiol 2012;63:282-3.

Dr Ankita Chandel

Dr RKGMC Hamirpur