Recurrent thyroglossal duct cyst presenting as upper airway obstruction: A case presentation and review of the literature

Abstracts population. Accurate preoperative diagnosis and subsequent adequate surgical excision are essential to prevent recurrence. The Sistrunk procedure is the surgical approach most often advocated. Although rare, treatment failure is most commonly attributed to the failure to perform adequate hyoid bone excision and dissection of the tract to the base of tongue. We report a case of a 7-year-old female who presented with airway obstruction 5 years after having had a Sistrunk procedure and excision of a lateral neck mass. Emergent tracheotomy and marsupialization of the base of tongue cyst were performed. After the diagnosis of recurrent thyroglossal duct cyst was established, core excision of the foramen cecum was performed transcervically when the cyst recurred a third time. The literature on recurrent thyroglossal duct cysts is reviewed and a discussion of its embryology, pathophysiology, epidemiology, presentation, treatment and prognosis is presented in an effort to increase awareness of this situation. DOI: 10.1016/j.ijporl.2007.09.029

Subcutaneous emphysema, pneumomediastinum and epidural emphysema in a child due to foreign body aspiration mimicking croup syndrome Ener Cagri Dinleyici *, Kadir Kocak, Huseyin Ilhan, Ragip Ozkan, Rabia Tutuncu, Ozcan Bor Department of Pediatrics, Pediatric Surgery and Radiology, Eskisehir Osmangazi University, Faculty of Medicine, TR-26480, Eskisehir, Turkey Epidural emphysema (pneumorachis) is a rare condition and usually accompanies subcutaneous emphysema or pneumomediastinum. We present a 18-month-old boy with pneumomediastinum, subcutaneous emphysema and epidural emphysema due to foreign body aspiration mimicking croup syndrome. He was admitted to emergency unit with the complaint of respiratory distress and noisy breathing. Physical examinations revealed inspiratory stridor and tachypnea. His clinical status has been worsened in spite of supportive treatment. Computerized thorax tomography showed pneumomediastinum, subcutaneous emphysema at the cervical region and epidural emphysema. A plastic part of toy was removed through a bronchoscope from the trachea and his respiratory distress was completely resolved after bronchoscopy. Children with foreign body aspiration may be admitted to emergency unit with different clinical findings mimicking asthma or respiratory infections. Foreign body

139 aspiration should be considered in children with pneumomediastinum, subcutaneous emphysema or epidural emphysema and diagnostic and also therapeutic bronchoscopy should be done immediately. DOI: 10.1016/j.ijporl.2007.09.030

The cutting balloon for endoscopic dilatation of pediatric subglottic stenosis K. Watters *, J. Russell Department of Pediatric Otorhinolaryngology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, Ireland In recent years, the increasing use of endoscopic techniques for management of pediatric subglottic stenosis has become evident. However, two problems encountered with conventional balloon dilatation are that of re-stenosis and distal balloon migration. We report a novel technique of endoscopic dilatation using the Peripheral Cutting BalloonTM Microsurgical Dilatation Device in a 4-yearold child with symptomatic Cotton Grade 2 subglottic stenosis. The presence of microsurgical blades on the balloon allows for more secure placement of the balloon at the level of the stenosis, preventing migration and allowing for more accurate dilatation under less pressure decreasing re-stenosis rates. We recommend that the cutting balloon be used as first line treatment in pediatric subglottic dilatation. DOI: 10.1016/j.ijporl.2007.09.031

Nasal ala rhabdomyosarcoma misdiagnosed as a facial infection Melanie Duval a, Ricardo Faingold a,b, Anne-Sophie Carret a,c, Sam J. Daniel a,d,e,* a McGill University, Montreal, Quebec, Canada b Montreal Childrens’ Hospital, Department of Radiology, Canada c Montreal Childrens’ Hospital, Department of Hematology-Oncology, Canada d McGill Auditory Sciences Laboratory, Canada e Montreal Childrens’ Hospital, Department of Otolaryngology, 2300 Tupper Street, Montreal, QC H3H 1P3, Canada We present the case of an 18-month-old female with nasal ala swelling thought to be of infectious etiology. There was no response to multiple courses of oral and topical antibiotics. Biopsy of the lesion