Acquired subglottic cysts: Report of three cases and review of the literature

Abstract

Acquired subglottic cysts are an infrequent cause of stridor in infants, which has been in- creasingly reported in the last decades. Its appearance is related to prematurity and intuba- tion in the neonatal period. Histologically, findings are characterized by an obstruction of the mucosal glands, due to squamous metaplasia of the respiratory epithelium. This con- dition usually requires a high index of suspicion to be diagnosed, as it can be misdiagnosed as croup, laryngomalacia or asthma. Flexible nasendoscopy allows an initial exploration of the larynx, but direct laryngo-tracheo-bronchoscopy in the operating room is the diagnostic gold standard. There are several techniques for its management, but the most frequently used are cold-steel marsupialization and laser. Recurrence is common, and some authors have used mitomycin C and antireflux therapy to try to decrease it. However, up to date, there is a lack of high-quality evidence, regarding the ideal management of this pathology, which prevents reaching a consensus. In this article, we present three clinical cases of pre- mature patients who were diagnosed with subglottic cysts, treated in a tertiary pediatric hospital.