Sonographic demonstration of a congenital laryngeal cyst.

Congenital laryngeal cyst is a rare cause of respiratory distress in the neonate and infant. 1 This soft tissue mass of water density is located inside an aryepiglottic fold. 2 Its diagnosis classically rests on endoscopy and radiography, yet it may also be made through ultrasonography.We report one case of laryngeal cyst diagnosed by ultrasonography in a neonate and illustrate the role of cervical sonography in infants with stridor. CASE REPORTA premature 34 week old female newborn infant of a triplet pregnancy was admitted in the neonatal unit with moderate axial hypotonia.A few hours later, she was found to be suffering from respiratory distress and stridor.Clinical examination revealed a premature hypotonic baby with respiratory retraction of suprasternal and infrasternal soft tissue, stridor, and regurgitation.The abdomen was slightly distended.Chest radiograph and arterial blood gas determination showed normal results, and a laryngeal abnormality was suspected.Cervical ultrasonography showed a cystic mass 12 mm in diameter at the right aryepiglottic fold, displacing the glottis toward the left side (Fig. 1).No flow was detected with Doppler ultrasonography.The ultrasonographic findings suggested the diagnosis of aryepiglottic cyst.Limited endoscopic marsupialization was performed but with transient clinical improvement.Ultrasonography revealed persistence or recurrence of the cyst, and a secondary complete removal of the cyst was performed endoscopically (Fig. 2).Microscopic examination revealed a mucinous cyst.No recurrence was detected on sonographic follow-up, and deviation of the glottis was reduced.The infant is now 32 months old and is completely asymptomatic.On an ultrasonogram, the glottis is no longer deviated (Fig. 3).