Management of pediatric subglottic cysts using the Bugbee fulgurating electrode.

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.