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Masters of Surgery Video Presentations

Pediatric Otolaryngology

Session: Masters of Surgery Videos 1

Neonatal Endoscopic Cold Steel Vallecular Cyst Marsupialization

Saturday, October 11, 2025
9:37 AM - 9:44 AM EDT
Location: 120
Disclosure(s):
Sean S. Evans, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Nathaniel S. Neptune, MD, MBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: Vallecular cysts are rare but important causes of neonatal stridor and dysphagia. When present, they can cause aspiration and dyspnea or apnea. They are readily identified on flexible fiberoptic laryngoscopy, and treatment is solely surgical though multiple techniques exist.

We present a 6-week old infant with coughing, choking, and gasping with feeds admitted for workup. Flexible laryngoscopy demonstrated a large, well circumscribed vallecular cyst.

The decision to excise versus marsupialize is based on surgeon preference, however, we propose that cold steel marsupialization results in less tongue base dissection and lower opportunity for inadvertent iatrogenic injury.

We provide our technique including needle decompression, and three handed endoscopic technique. We believe this technique allows improved visualization and enhances educational purposes. We describe the post op course and highlight that endoscopic cold steel marsupialization of vallecular cysts is a safe and effective treatment method with improved visibility, minimal recovery and acceptably low recurrence rate.

    Lead Presenter(s)

  • SE

    Sean S. Evans, MD

    Assistant Professor Otolaryngology - Head and Neck Surgery
    Children's Healthcare of Atlanta
    Atlanta, GA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Presenter(s)

  • Nathaniel S. Neptune, MD, MBA

    Resident Physician
    Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine
    Atlanta, GA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.