A 29-year-old woman found what looked like a balloon inside her mouth when she checked
her mouth with a mirror after a dental check-up. There was no symptom except the “balloon”
behind her tongue; she was surprised and worried about the strange experience. She
had no history of drinking or smoking.
We examined her using an oral pharyngeal scope [1] and at first could not find any abnormality inside her mouth. However, when she
answered “OK,” she strained her tongue forcefully and the “balloon” suddenly appeared
on the right side behind the base of the tongue ([Video 1]).
Video 1 A “balloon” inside the mouth. We could not find any abnormality inside the mouth
while observing with an oral pharyngeal scope. When the patient strained her tongue
forcefully, a “balloon” suddenly appeared on the right-side, behind the base of the
tongue.
Using an electrolaryngeal fiberscope, the “balloon” appeared from her vallecula when
she strained her tongue ([Fig. 1]) and did not appear at any other time. During Valsalva maneuvers ([Fig. 2]) the balloon disappeared, which suggested that air filled sacs did not communicate
with the laryngeal lumen. Computed tomography imaging ([Fig. 3]) showed an air-filled space between the base of the tongue and the epiglottis.
Fig. 1 Laryngeal vallecula view with a nasopharyngeal fiberscope. When the patient strained
her tongue forcefully, a “balloon” suddenly appeared on the right side, from behind
the base of the tongue.
Fig. 2 Laryngeal vallecula view with nasopharyngeal fiberscope. During Valsalva maneuvers
the “balloon” disappeared.
Fig. 3 Computed tomography showed an air-filled space (arrow) between the base of the tongue
and the epiglottis.
The most common congenital laryngeal cysts include saccular cysts, laryngoceles, and
ductal cysts [2]
[3]. A saccular cyst closed from the laryngeal lumen presents as a cyst of the lateral
larynx, the so‐called congenital cyst or lateral saccular cyst [2]. Our suspected diagnosis was thyro-tongue duct cyst. Complete resection for such
cases is recommended as the surgical outcome is excellent [3]. However, after 12 years, the patient has never agreed with surgery because her
child was still young and the “balloon” caused no ill effects over these 12 years.
Endoscopy_UCTN_Code_CCL_1AB_2AB
Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques
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