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Case Report/Case Series |

Management of Pediatric Subglottic Cysts Using the Bugbee Fulgurating Electrode

Matthew A. Richardson, MD1; Tyler W. Winford, MD1,2; Byron K. Norris, MD1,3; J. Mark Reed, MD1
[+] Author Affiliations
1Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson
2Department of Otolaryngology, Wake Forest School of Medicine, Winston Salem, North Carolina
3ENT of Athens, Athens, Georgia
JAMA Otolaryngol Head Neck Surg. 2014;140(2):164-168. doi:10.1001/jamaoto.2013.6122.
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Importance  Subglottic cysts are an important cause of pediatric airway obstruction. We describe the typical presentation and management of subglottic cysts, with historical recurrence rates between 12.5% and 71.0%, and treatment using the Bugbee fulgurating diathermy electrode as a technique to successfully manage subglottic cysts with a low recurrence rate.

Observations  A retrospective review was performed on 16 consecutive patients treated for subglottic cysts at a single tertiary-care facility. The mean gestational age was 26.9 weeks, with a male to female ratio of 4.3:1. All patients had at least 1 prior intubation, with a mean of 1.8 prior intubations per patient. Biphasic stridor was the most common presenting symptom, occurring at a mean of 7.3 months after the last extubation. At the time of diagnosis, patients were found to have a mean of 1.6 cysts, and the left lateral subglottic wall was the most common location of unilateral cysts. Nine patients (56%) had an associated laryngeal pathologic condition. Symptomatic cyst recurrence occurred in only 6% of patients, and no major complications were reported.

Conclusions and Relevance  This review presents a treatment method for subglottic cysts that is safe and effective and has a symptomatic recurrence rate lower than previously reported.

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Figure.
Subglottic Cysts

A, Unilateral obstructing cyst on the left lateral subglottic wall. B, Multiple bilateral obstructing subglottic cysts.

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