Stridor Secondary to Acquired Subglottic Cyst: Rarity Makes it Missed

  • Goh Bee SeeEmail author
  • Izham Mesran
Clinical Report


Subglottic cysts (SGCs) are a rare cause of airway obstruction in children. Medical advances, higher survival rates for preterm infants, and improved diagnostic equipment have increased the number of reported cases of SGCs over the last three decades, the majority occurring in infants who had been extremely premature neonates and had suffered from respiratory distress, therefore having been intubated and managed in neonatal ICUs. Symptoms of laryngeal cysts depend on the size and the location of the cyst and include a change in the tone of voice, dysphonia, hoarseness, dysphagia, stridor, and dyspnea. This condition is often misdiagnosed as laryngomalacia, asthma, croup, or other diseases, due to the fact that it manifests as recurring respiratory infections, stridor, and wheezing. Death can occur in severe cases that are not treated. When present, it may account for severe inspiratory stridor that compromise the airway. The accepted gold standard treatment is direct laryngoscopy with marsupialization of the cyst to prevent recurrence. Two cases of subglottic cyst in our centre are described here. Although all cases presented differently, but in both of our cases, which have previous history of intubation with prematurity were initially diagnosed as laryngomalacia and croup.


Subglottic cysts Acquired cyst Stridor Laryngeal cyst 


Compliance with Ethical Standards

Conflict of interest


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Research Ethics Committee, The National University of Malaysia operates in accordance to the International Conference of Harmonization Good Clinical Practice Guidelines.

Informed Consent

Informed consent was obtained from the individual participant involved in this study.


  1. 1.
    Joshi VV, Sharad GM, Stern L, Wiggleworth FW (1972) Acute lesion induced by endotracheal intubation. Am J Dis Child 124:646–649CrossRefGoogle Scholar
  2. 2.
    Smith SP, Berkowitz RG, Phelan PD (1994) Acquired subglottic cysts in infancy. Arch Otolaryngol Head Neck Surg 120(9):921–924CrossRefGoogle Scholar
  3. 3.
    Smith JD, Cotton R, Myer CM (1990) Subglottic cysts in the premature infant. Arch Otolaryngol Head Neck Surg 116:479–482CrossRefGoogle Scholar
  4. 4.
    Couriel Jonathan M, Phelan Peter D (1981) Subglottic cysts: A complication of neonatal endotracheal intubation? Pediatrics 68:103PubMedGoogle Scholar
  5. 5.
    Bauman NM, Benjamin B (1995) Subglottic ductal cysts in the preterm infant: association with laryngeal intubation trauma. Ann Otol Rhinol Laryngol 104:963–968CrossRefGoogle Scholar
  6. 6.
    Watson GJ et al (2007) Acquired paediatric subglottic cysts: a series from manchester. Int J Paediatr Otorhinolaryngol 71:533–538CrossRefGoogle Scholar
  7. 7.
    Wigger JH, Tang P (1968) Fatal laryngeal Obstruction by iatrogenic subglottic cyst. J Paediatr 72:815–820CrossRefGoogle Scholar
  8. 8.
    Michell DB, Irwin BD, Bailey CM, Evans JNG (1987) Cysts of the infant larynx. J Laryngol Otol 101:833–837CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2016

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology-Head Neck SurgeryUniversiti Kebangsaan Malaysia Medical CentreCheras, Kuala LumpurMalaysia

Personalised recommendations