Epithelial epiglottal cyst causing airway obstruction excised by 445 nm blue diode laser, a case report.

INTRODUCTION

Epithelial epiglottal cysts are rare benign laryngeal lesions that may cause airway obstruction or dysphagia, often linked to chronic irritation such as smoking. Surgical excision is indicated for symptomatic cases, with laser technologies like the 445 nm blue diode laser offering precision and hemostasis. This case report describes the use of this novel laser in a complex patient, highlighting its efficacy.

CASE PRESENTATION

A 61-year-old male with a 40 pack-year smoking history and prior myocardial infarction presented with dyspnea, hoarseness, and neck discomfort. Laryngoscopy revealed benign epiglottic cysts, which enlarged over a year. The cysts were excised using a 445 nm blue diode laser via rigid microlaryngoscopy. Despite ongoing aspirin therapy, no significant complications occurred. The patient was discharged with no complaints whatsoever. Histology confirmed benign epithelial cysts. Postoperative laryngoscopy showed minimal edema on day 1, resolving by day 7, and no complaints by two months.

DISCUSSION

The 445 nm blue diode laser's photoangiolytic and cutting properties minimized bleeding and tissue trauma, outperforming traditional surgery and CO2 laser in reducing edema and recovery time. The patient's rapid recovery, compared to longer healing in CO2 laser or traditional surgery cases, underscores the laser's advantages, particularly in high-risk patients on antiplatelet therapy.

CONCLUSION

This case demonstrates the 445 nm blue diode laser's efficacy in excising epiglottal cysts, offering rapid recovery and minimal complications. It highlights the potential of advanced laser technologies for managing rare laryngeal lesions in complex patients.