A Clinical Study and Treatment of the Cysts on Epiglottis, Vallecula, and Tongue Base

Lee, Joon Kyoo

Abstract

BACKGROUND AND OBJECTIVES
Cysts on the epiglottis, vallecula, and tongue base are relatively common and usually need surgery with laser under the adjustable laryngoscope. The present study was performed to evaluate the clinical outcome and usefulness of an adjustable laryngoscope and a customized electrocautery. SUBJECTS AND METHOD: Retrospective study was performed in 41 patients with cysts on epiglottis, vallecula, and tongue base and we analyzed the clinical characteristics and treatment outcome by using an adjustable laryngoscopic surgery. RESULTS: There were 33 cases of epiglottic cyst, 4 cases of vallecular cyst, and 4 cases of tongue base cyst. Histopathologic results revealed 34 epithelial cysts and 3 tonsillar cysts. Of 4 tongue base cysts, 2 cases were thyroglossal duct cysts. Excision was done in 35 cases and marsupialization in 6 cases. The adjustable laryngoscope offered a good surgical view on the lingual surface of epiglottis and vallecula but revealed limitations for the tongue base; the customized electrocautery did not cause significant surgical problems or tissue damage. Seven patients had persistent symptoms such as those of gastroesophageal reflux after surgery. Recurrence was observed in 2 cases at 5 months following the operation and at 3 1/2 years, respectively. CONCLUSION: Cysts on the epiglottis, vallecula, and tongue base were successfully operated with a customized electrocautery under the adjustable laryngoscope. Patients with vague symptoms such as those of gastroesophageal reflux need to be carefully selected for the surgery and long-term follow-up is required for recurrence.