What are congenital saccular cysts?

Congenital saccular cysts of the larynx is a rare condition that appears at birth. These cysts develop in the laryngeal saccule of the larynx. Their severity depends on size, location and degree to which they block the infant airway.

Signs and symptoms

Congenital saccular cysts will be present at birth, but sometimes the symptoms are not severe for days or weeks. Symptoms include: 

• Stridor (noisy breathing)
• Severe respiratory distress

Testing and diagnosis

To diagnosis this condition, your child's doctor will perform a flexible fiberoptic exam while the child is awake. This will reveal any lesions in the larynx. An MRI is also helpful for defining the extent of the cyst. Definitive diagnosis and treatment is made by microlaryngoscopy and bronchoscopy.

See how saccular cysts appear in the pediatric airway.

Treatments

Immediate treatment is usually necessary because of the severity of airway obstruction in the infant. Treatment will depend on the location of the cysts:

• Cysts that are located on the inside of the larynx are removed endoscopically using a CO2 laser or microlaryngeal instruments. A portion of the cyst wall is removed to hinder reoccurrence. 
• Cysts that are laterally based on the utricle of the larynx (usually larger in size) are removed through an open surgical approach with a small incision on the side of the neck. A small portion may be removed and the cyst is then exposed and dissected out. Your child may need a breathing tube overnight after the procedure.

Your doctor may repeat the microlarnygoscopy and bronchoscopy one to two months later to make sure the cyst has not reformed.