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Ventricular Cyst
case presentation


    73 year old lady with 4-week history of hoarseness. History of smoking and drinking, but none recent. Some swelling of her ankles in the same time-frame as her vocal problems. No other symptoms referable to her head-neck region.

Initial examination

    The patient presents with a moderately dysphonic voice. Her voice is judged overall to be moderately dysphonic, with regular pitch breaks and hoarseness, but retaining a normal pitch range (26 semitones). These characteristics are heard in the passage below.

    Preoperative reading of the "Three Bears passage".
    Preoperative laryngoscope images. Left: maximally closed glottis. Right: open glottis on inhalation. Click here to compare these two images.

    Stroboscopic endoscopic examination shows that neither vocal fold seems to be at all affected by the lesion, and that the visible vibrational interruption is merely from the physical size of the cyst. Some slight damage to the contralateral vocal fold (slight erythma opposite the site of the cyst) may be due to traumatic collision with the cyst. Her vocal cords seem to move normally around the cyst.

Preoperative Strobed Video recording.

Operation and result

    Under general anaesthesia, the cyst on the false folds was removed. The lesion was grasped and removed by microscissors. The lesion was sent for pathological analysis and was found to be a laryngeal cyst with papillary oncocytic changes.

    At her two-month followup, there was no evidence of cyst recurrence, and the patient's voice had returned to normal.

Intraoperative images. Left: immediately before excision of cyst. Right: after microscissor excision of the cyst.

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