What is a Vallecular Cyst?

Pre-operative view of a vallecular cyst

 

Initial drainage of cyst fluid

Vallecular cyst is the name of specific type of cystic fullness in the area between the very back of the tongue (base of tongue), and the epiglottis. This area of the body is the empty space that is called the vallecula. Typically, there is quite a bit of lymphoid tissue in this location, similar to that found in the tonsils.

Occasionally, a cystic fullness is found in this area. With passage of time, the cyst might increase in size. There is usually no associated pain. However, if the cyst is of a certain size, eventually the patient might feel a sensation of a ball in the throat as well as occasional problems with swallowing. In severe cases, this may also give the patient symptoms of shortness of breath due to lack of adequate breathing passages around it.

Vallecular cysts are usually benign in pathology, and expose no immediate danger from a cancer prospective. However, with the passage of time, an increase in the size of the cyst might give the patient more symptoms.

The treatment for vallecular cyst is surgical. This is usually done with the patient under general anesthesia. The cyst is visualized using microscopic instruments. Smaller cysts could be removed entirely, and larger cysts which are felt to be embedded within the tissues of the tongue, are usually drained and marsupialized (the inside of the cyst is left exposed to the outside area). This is a relatively benign procedure, and the patients can go home the same day. Most patients resume physical activities immediately, and they may need to refrain from crunchy foods for few days.

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  2. Could a 10mm vallecular cyst cause eppiglotitis ?

    Comment by jane on March 28, 2018 at 1:44 pm

  3. Most of these cysts usually do not get infected, nor do they cause infection in other areas. But it is not impossible for an infection to happen in an isolated case.

    Comment by DrNamdar on April 4, 2018 at 1:39 pm

  4. Dr. Namdar,

    I had a surgery to remove a cyst on base of tongue 4 months ago. It was biopsied and found to be non cancerous. Yesterday, I went for follow up and found out the cyst is back (10mm size). I am worry if it is cancerous? What kind treatment should I get? Surgery again? Will it come back again?

    Your response is greatly appreciative.

    Thank you,

    Comment by Minh on April 24, 2018 at 3:08 pm

  5. I imagine you are talking about vallecular cysts. Unfortunately, so do recur, and might need attention again. These are rarely, if ever, cancerous. A biopsy of the removed portion of the cyst would clarify the diagnosis.

    Comment by DrNamdar on April 27, 2018 at 5:26 pm

  6. I have a cyst in my throat which has already burst on its own. It is not infected. The doctor I went to recommended having surgery to remove it. Do I need o have this surgery? I would like to hear your suggestions
    Thank you

    Comment by Bilan T on May 5, 2018 at 2:08 pm

  7. I had surgery for vallecular cysts about 10 weeks ago. I have constant mucus in the back of my throat and have to cough it up to clear my throat. My throat has not felt clear since the op. It leaves an awful salty taste in my mouth. Is this likely to settle or is it a common, on-going side effect of this surgery? Thank you

    Comment by Jill on May 11, 2018 at 11:39 am

  8. It might be secretions from the area of the cyst, same fluid that used to build up and create the cyst. Most of them eventually heal over and reduce their production with time.

    Comment by DrNamdar on June 11, 2018 at 2:58 pm

  9. Dr. Namdar,
    My ENT Doctor acted surprise when he saw recurrence of my cyst on base of tongue after surgery follow up. It’s not a feeling when my Doctor isn’t sure why the cyst came back. Even though on the previous post you indicated it’s rarely cancerous, I am still want to be vigilant because I was told that early detection of cancer has better chance of treatment and overall survival rate. Should I go to MD Anderson or Mayo Clinic for expertise diagnosis? Are there any larynx cyst experts in Indiana or surrouding areas that I can visit for second diagnosis and opinion?
    Thank you,

    Comment by Minh Nguyen on May 27, 2018 at 10:59 am

  10. Most Laryngologists (a sub-specialty of ENT) should be able to diagnose and treat these cysts. A referral to a cancer specialty hospital is usually made once (heaven-forbid) a diagnosis of cancer is confirmed.

    Comment by DrNamdar on June 11, 2018 at 2:56 pm

  11. Nurse called and told me I am positive for H Pylori. She put me on triple therapy antibiotics, Lansoprazole-Amoxicillin-Clarithromycin. for 14 days. I won’t get to see my doctor for another 10 weeks after the completion of triple therapy. But I am very curious to find out the long term effect on my health if I have Pylori for years and don’t even know? Can/will it cause growth of cysts in base of tongue? What other serious health issues will it cause?
    Thank you,

    Comment by Minh Nguyen on June 16, 2018 at 4:25 pm

  12. Those are actually very good and valid questions to be discussed with either you primary care or GI specialists.

    Comment by DrNamdar on June 20, 2018 at 4:36 pm

  13. My ENT found a slight swelling of the vallecular when I was there to examine my silent acid reflux.
    Are they related? He also mention that it was only on my left vallecular and not only the right vallecular. Does that make any difference?

    Comment by Christopher Chew on July 22, 2018 at 1:06 pm

  14. Although reflux issues can affect the vallecula, there are other reasons that swelling of the vallecula space could be evident. It is very important to continue observation of this area with frequent endoscopy.

    Comment by DrNamdar on July 23, 2018 at 3:50 pm

  15. I just received my cat scan results. Couple rounded cystic structures in left valleculae 8mm, central Valleculae 6mm and posterior to the right epiglottis 6mm.
    Impression:
    Several small cysts in the epiglottis region. These are of unclear etiology. Endoscopy is recommended for further evaluation.
    Can you please explain these findings with me and help me to understand exactly what kinda questions I should be asking when I see my ent next week.

    Comment by Sarah on August 4, 2018 at 7:13 am

  16. Most vallecular cyst are single lesions. It seems that you have multiple smaller ones. These could be due to some kind of trauma, or auto immune disease that causes them to form in new places.

    Comment by DrNamdar on October 11, 2018 at 2:37 pm

  17. I have recently been diagnosed with a supraglottic cystic structure which may represent an epiglottic cyst on my vallecula. I am due to have major lumbar fusion surgery and was wondering if this should be removed prior to surgery. Will it be a problematic for 7 to 8 hours of anesthesia?

    Comment by Robynne Bruggeman on August 9, 2018 at 10:13 pm

  18. Most of these cysts are small and would not get in the way of surgery or the anesthesia. It is best if your ENT communicates in advance about the extent of the cyst with both your neck surgeon and the anesthesiologist.

    Comment by DrNamdar on October 11, 2018 at 2:34 pm

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  20. my 19yr old son is getting this surgery done next week and i am super worried as he is . he has anxiety and has lost alot of weight because he is afraid of eating. so worried. being done at LIJ New Hyde Park. by Dr. Kamdar

    Comment by yvette santiago on August 24, 2018 at 7:41 am

  21. Good luck.

    Comment by DrNamdar on October 11, 2018 at 2:33 pm

  22. Is there any relationship or association between H Pylori, acid reflux, and vallecular cyst on base of tongue? I was treated for H Pylori twice with regimens of antibiotics in the last 12 months. And both times, it came back after breath tests. Now GI want to do another endoscopy to take sample and culture it and I am not sure why. What other possible treatments for recurrent H Pylori besides antibiotics?

    Thank you

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  26. I have just had a diagnosis of a cyst between the back of my tongue and the voice box. The doctor is going to revisit in six weeks. However it feels uncomfortable especially after eating. Is there anything I can do in the mean time to make it more comfortable?

    Comment by Thorpe abbitts on November 13, 2018 at 7:20 pm

  27. Unfortunately, there is no specific medicine to shrink the size of the mass. We can treat with antibiotics if the re is suspicion for infection, give antihistamines if we think there is a reactive process, or use mucolytics (like Mucinex) to help with the saliva. Otherwise, surgical decompression is the only other gold standard treatment.

    Comment by DrNamdar on December 13, 2018 at 1:49 pm

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  29. Thanks so much for your feedback!

    Comment by DrNamdar on December 13, 2018 at 1:45 pm

  30. Our baby was diagnosed with failure to thrive at 5 weeks old. We were admitted to the hospital to figure out what the problem was. After 4 days ENT was brought in and they did a scope, finding a vallecular cyst. He had surgery 3 days later to have it removed. Jump forward 10 weeks and he is now gaining weight regularly but still not a huge fan of eating (sometimes struggles) and still sounds pretty heavy with breathing (could just be congestion since it’s winter). What are the chances of the cyst recurring? Should we schedule a follow up with the ENT doctor? We were told we after discharge from the hospital that we didn’t need to see ENT again, unless issues arise. But after going through it all once the thought is always in the back of our minds that something else will go wrong. Thank you!

    Comment by Alyssa on January 15, 2019 at 7:46 pm

  31. Having a follow up visit is always a good idea, specially if you feel some of the symptoms are not quite right. Most likely they will look again with the flexible scope to make sure.

    Comment by DrNamdar on January 23, 2019 at 3:35 pm

  32. I have had 2 surgeries to remove vallecular cysts and one marsupialation on a cyst that almost blocked my whole airway. I now have another cyst. It seems like every year I get one or two cysts (at the same time). I feel like I’m just getting my throat continuously chuncked out. I don’t feel like throat surgery is a healthy thing to continuously keep doing. Not to mention, it’s a huge financial strain. My doctor is baffled as to why the cysts keep occurring, and says there isn’t much research out there to help him with the situation. Do you have any resources or recommendations that I might turn to for help in this situation? Thanks for your time.

    Comment by Amanda on February 23, 2019 at 1:42 am

  33. I would agree that valledupar cysts are usually not a multiply recurring phenomenon. Specially if the cyst sac was removed in its entirety, then logically the nidus for any future recurrence should be gone. Otherwise you might be suffering from an additional mucosal surface disease that is predisposing you to this kind of recurrence. Occasionally we seek the advice of our Rheumatology colleagues if suspect the latter as a cause.

    Comment by DrNamdar on March 20, 2019 at 3:12 am

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  35. I have been feeling a lump in my throat when swallowing and severe obstructive sleep apnea. A laryngoscopy revealed two significant sized vallecular cysts on my epiglottis. I also have laryngeal spasms. A ct scan is upcoming to see how deep the cysts are. Are they removed during surgery usually with laser? Is it considered a dangerous operation? Thank you.

    Comment by Teri Clark on December 5, 2019 at 10:56 pm

  36. Most of these cysts are benign findings. Many of them could be even observed over time if small enough and giving you no symptoms. The surgery is usually done through the throat. Either with endoscopic or laser techniques. Most people should be able to go home the same day.

    Comment by DrNamdar on April 28, 2020 at 2:17 pm

  37. Dr Namdar I greatly appreciate all the information on your site. I am having surgery on a 6 mm vallecular cyst at the base of my tongue on March 23. Of course I’m somewhat nervous about it. I was told they were going to remove the top and test it to make sure it was benign. If it isn’t then I will need a follow up surgery. I guess I don’t know why they don’t remove the entire cyst while they are in there. Is it because these types of cyst are rarely canerous so by just removing or opening it up it will heal on its own and be less of a procedure? Thank you for your time the information I found on your site was certainly very helpful.

    Comment by Mike on March 14, 2020 at 5:52 pm

  38. In most cases you don’t need to remove the entire cyst. You just remove the top paper-thin layer and expose the base to the inside of the throat. In order to remove the entire cyst, we would have to remove also a portion of healthy tongue tissue at the base of the tongue, which makes the procedure much more painful.

    Comment by DrNamdar on April 28, 2020 at 2:10 pm

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