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BMJ Case Reports 2013; doi:10.1136/bcr-2013-009180
  • CASE REPORT

An unusual presentation of an infected vallecular cyst presenting as supraglottitis

  1. Eugene Omakobia2
  1. 1Bristol Medical School, University of Bristol, Bristol, UK
  2. 2Department of Ear, Nose and Throat Surgery, University Hospitals Bristol, Bristol, UK
  1. Correspondence to Vijay Pattni, vp8253{at}bristol.ac.uk

Summary

A 50-year-old gentleman presented to the emergency department with a 24 h history of stridor, dysphonia, dysphagia and vomiting. On examination, the patient had fever and tachycardic. There was no palpable cervical lymphadenopathy. Flexible nasendoscopy and lateral neck x-ray revealed soft tissue swelling around the epiglottis. The swelling subsided with conservative management of intravenous antibiotics and steroids, only to later reveal a vallecular cyst, which was confirmed on microlaryngoscopy. The cyst was subsequently deroofed and sent for biopsy. Histological examination revealed an infected, benign vallecular cyst consisting of a squamous epithelium with underlying lymphoid tissue. In adults, vallecular cysts are usually asymptomatic, but can become infected and initiate acute supraglottitis, potentially leading to life-threatening airway obstruction. The case described here, although rare, highlights how early definitive diagnosis and management of vallecular cysts can lead to significantly improved patient outcomes.

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