Congenital tongue base cyst as uncommon cause of laryngeal stridor in an infant

Abstract

Introduction Congenital tongue base cysts are uncommon in everyday clinical practice and they could be asymptomatic or cause stridor, respiratory distress, and asphyxia. We are presenting a case of a two-month-old infant with the symptoms of stridor and the acute respiratory insufficiency caused by congenital tongue base cyst.

Case outline A two-month-old apyretic male infant was admitted to the hospital with the symptoms of severe dyspnea, nonproductive cough, and stridor. Due to severe respiratory insufficiency the infant was on mechanical ventilation. Computed tomography scans of the thorax and neck was performed along with the application of the intravenous contrast where a cystic formation was shown. The depicted formation narrowed the lumen of oropharynx which is the same as the size of valleculas (3 mm). The formations pressed both valleculas, more significantly the left one. The same day the marsupialization of the cyst was done and the material was sent to the pathohistological analysis (the report of the pathologist indicates the cyst of the thyroid channel).

Conclusion Clinical manifestations of the cyst depend on the level of obstruction and can be presented as inspiratory stridor, apnea, cyanosis, chronic coughing, and feeding difficulty. The flexible nasopharyngeal laryngoscopy or bronchoscopy, computed tomography and magnetic resonance imaging help consider the differential diagnosis. The symptoms of stridor were removed completely after applied marsupialization of the cyst.

Keywords: airway obstruction; thyroglossal cyst; stridor; respiratory insufficiency