Adult vallecular cyst: Thirteen-year experience

Abstract

OBJECTIVE: To assess the characteristics of adult vallecular cyst. STUDY DESIGN AND SETTINGS: A retrospective chart review from a university affiliated hospital. SUBJECTS AND METHODS: Clinical manifestations and airway management of 38 consecutive adult patients with vallecular cyst admitted between 1992 and 2004 were studied. RESULTS: Two distinct groups were identified: infected (n = 24) and noninfected (n = 14). Twenty-two (91.7%) patients of the former group had acute epiglottitis with an abrupt onset culminating in abscess formation in 19 (79.2%) and airway compromise in 9 (37.5%) compared with none in the noninfected group (P = 0.006). In 4 (18.2%) of 22 patients, the origin of the infected vallecular cyst was evident only after symptoms subsided. Three patients had recurrent acute epiglottitis. The noninfected group had a relatively prolonged mild clinical course. CONCLUSIONS: Two types of vallecular cysts were characterized. Abscess formation was the hallmark of adult infected vallecular cyst. SIGNIFICANCE: To improve patient care, endoscopic follow-up is advocated. In patients with recurrent episodes of acute epiglottitis, imaging is recommended.