Subglottic cysts (SGC) have long been regarded as a rare cause of airway obstruction but through increased awareness an increase in the number of cases of SGC has been reported.
Objective: This paper describes the pathogenesis and management of SGC.
Design: Retrospective case series. Ethical approval not sought.
Setting: Royal Manchester Children's Hospital.
Patients: Two hundred and six new referrals for direct laryngotracheobronchoscopy (DLTB) were identified from records between September 2003 and September 2005.
Main outcomes measured: Age at birth, sex, length of intubation, presenting symptoms, age at presentation, DLTB findings, interventional procedures, and follow-up DLTBs.
Results: Fourteen out of 206 (6.8%) infants were diagnosed as with subglottic cysts. This represented the fourth most common cause of upper airway pathology. Thirteen out of 14 (93%) infants were preterm (26.8 weeks S.D. 25.3-28.3 weeks). All infants had been intubated ranging from 1 to 180 days (median 42 days). The onset of symptoms ranged from 1 to 13 months (median 4.25 months). Initially, 8/14 (57.2%) infants had SGC cysts marsupialised with microforceps. A further six cysts (50%) were decapped between 2 and 4 months and one between 6 and 12 months.
Conclusion: The number of cases of SGC has been increasing over the last three decades and represents the fourth most common causes of airway obstruction in our series. There is a delay in onset of symptoms and high rate of recurrence in the first 4 months. It is therefore prudent to reschedule further endoscopic evaluation between 2 and 4 months and after 6 months should the clinical need arise.