Airway obstruction from intralaryngeal extension of thyroglossal duct cyst in an elderly man: A case report

Objective@#To report an unusual presentation of thyroglossal duct cyst causing airway obstruction in an elderly man. @*Methods@# Design: Case Report Setting: Tertiary Government Training Hospital Patient: One @*Results@#A 71-year-old man with an anterior neck mass was brought to the Emergency Room due to progressive difficulty of breathing. A smooth, non-ulcerating right supraglottic mass obstructed the airway. Following an emergency high tracheotomy, contrast computed tomography scan of the neck revealed a hypodense mass with peripheral rim enhancement in the right supraglottis and an extralaryngeal component. Intra-operatively, a dumbbell- shaped cystic mass with a tract connected to the hyoid bone led to a Sistrunk procedure. Final histopathology findings were consistent with thyroglossal duct cyst. @*Conclusion@#It is possible for an elderly patient with impending upper airway obstruction, dysphonia, and neck mass to still have a benign and congenital thyroglossal duct cyst with intralaryngeal extension.

Clinical Characteristics and Management of Saccular Cysts: A Single Institute Experience

OBJECTIVES: A saccular cyst is defined as a dilated saccule of the larynx, filled with mucus, and is located between the false vocal cords and the thyroid cartilage. Although this uncommon laryngeal condition is benign in nature, it could lead to dyspnea, stridor, and airway obstruction, depending on its size and location. Furthermore, some saccular cysts have been associated with laryngeal carcinoma. This study aimed to characterize this rather uncommon laryngeal condition to aid in determining the proper management of this pathology. METHODS: Medical records were retrospectively reviewed of all patients with saccular cysts diagnosed and treated between 2006 and 2017 at a tertiary otolaryngologic care center. RESULTS: Seven patients with saccular cysts were identified (male:female=2:5; mean age, 34.1 years); two were pediatric patients. Surgical intervention was performed in all patients by laryngo-microsurgery using CO2 laser. There was no recurrence after the initial surgical treatment. CONCLUSION: Saccular cysts can be managed endoscopically using CO2 laser, without requiring an external approach. Therefore, an endoscopic approach should be actively considered for an optimal treatment outcome.