A RARE CASE REPORT ON VALLECULAR CYST

A male patient referred from general medicine to ENT OPD with the complaints of gradual onset and progressive difficulty in swallowing and occasional breathing difficulty for 4 days duration. His general examination was found be normal. Indirect laryngoscopy examination showed a smooth mass obscuring the visualization of laryngeal structures. Laryngeal examination was done by video laryngoscopy showing, a 5x5 cm cystic, globular mass occupying the vallecula , pushing the epiglottis posteriorly and partially occluding the laryngeal inlet. The patient was posted under general anaesthesia, jacksons suspension direct laryngoscope was passed and the vallecular cyst visualized. Grey, mucoid material was aspirated, following which the size of the swelling decreased, making intubation possible. Radiofrequency probe was applied. The cyst was cut and coagulated from its attachments. The cystic mass was removed in Toto and sent for histopathological examination, which was reported to be vallecular epithelial cyst. Postoperatively the patient improved and became asymptomatic. The general mode of treatment for such suspected abscess or cyst is marsupialization. But in this case radiofrequency was used to treat the patient. Although rare, vallecular cysts should be considered in the workup of dysphagia. Additionally, vallecular cysts factor into the differential diagnoses of voice difficulty, odynophagia, and dyspnea. Managing vallecular cysts via direct laryngoscopy and excision may lead to resolution of symptoms.