Objective: in neonates and infants, vallecular cyst is a benign cyst of the minor salivary glands which rarely present as upper airway obstruction and stridor. This study aims to present an incidental finding of vallecular cyst in an infant presenting with stridor, identify possible differential diagnosis of causes of stridor in neonates, determine definitive diagnostic procedure/s and treatment management for vallecular cyst.
Case: this is a case of a 15 day old male from quezon city, philippines, born term to a 25 year old g1p1 (1001) with no fetomaternal complications who was brought in due to fast breathing. At 10th day of life, patient presented with coughing episodes and interrupted feeding, and eventually fast breathing. Patient was then admitted and initially managed as a case of neonatal pneumonia, however while admitted at the ward, there was noted stridor. He was then referred to ent for co-management. He underwent flexible nasopharyngolarygnoscopy under sedation with topical anesthesia which showed presence of cyst in the vallecula. Other findings showed right true vocal cord paresis, laryngomalacia and laryngopharygneal reflux disease. He was then scheduled for elective excision of the vallecular cyst. Patient underwent direct laryngoscopy and marsupialization of vallecular cyst at 1 month old after pre-operative clearance. Airway was secured via nasopharyngeal intubation upon post surgical management of the patient.
Conclusion: although vallecular cysts are rare in the infant and neonatal period, potential life threatening condition may be evident. Thus, anticipatory measures for prevention of severe upper airway obstruction and respiratory distress should be observed once the diagnosis of vallecular cyst is made through airway management and through definitive surgical management to prevent mortality of the patient.