I nnovative Surgical Technique in the Management of Vallecular Cyst

Figure 2 : Line diagram illustrating vallecular cyst

excis ion using snare

Minimal bleeding from the wound was controlled with
direct pressure for a few minutes . The post-operative
period was uneventful and the patient was
discharged on the 2nd post-operative day. On review
one week later, the wound was found to have healed
completely and after 6 months, no recurrence was
noted.

D i s cu s s i on :

Vallecular cysts are retention cysts of the minor
salivary glands in the vallecula and base of the
tongue. Obstruction of the mucous glands leads to
cyst formation and continued secretion leads to a
corresponding increase in size of the cyst. They are
asymptomatic when small in size, but large cysts
may cause dysphagia and voice change. Majority of
patients presenting with vallecular cysts are in the
paediatric age gr oup, most of them being infants; (1 -
3) in infants and children it may also present with
upper aero-digestive tr act obstruction and stridor .
T he differential diagnoses include internal

thyroglossal duct cysts, dermoid cysts , lingual
thyroid,    teratomas,     lymphangiomas     and

haemangiomas .

T he conventional modalities of management of
vallecular cyst include mars upialisation, de-roofing or
excision.(4) These are done with either the CO2 laser
or by electrocautery. Repeated aspiration invariably
l eads to recurrence of the cysts .

T he technique adopted by us i.e., snaring of the cyst,
is a quick and effective way of surgical removal. This
procedure can be done with a set of tonsillectomy
instruments . This method is s afe, cost effective and
the result obtained is comparable with that by the
conventional techniques . Age does not restrict the
method of excision and snaring is a relatively simple
and in-expensive method of excision of vallecular
cysts.

R ef er en ces :

1 . T uncer U, Aydogan LB, Soylu L. Vallecular
cyst: a cause of failure to thrive in an
infant. Int J Pediatr Otorhinolaryngol. 2002
Sep 2; 65(2): 133-5.

2. Gutierrerz JP, Berkowitz RG, Robertson CF.
Vallecular cysts in newborns and young
infants . Pediatr Pulmonol. April
1999;27(4):282-5.

3 . Ku AS . Vallecular cyst: report of four cas es -
one with co-existing laryngomalacia. J.
Laryngol Otol. March 2000; 114(3): 224-6

4. P.E. Robin, Tan Olofsson. Tumors of the
Larynx . I n John Hibbert, Editor. S cott-
Brown's Otolargngology, 6th Ed,
Butterworth-Heinemann,1997    pp 1 - 1 1

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