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James' Story

Dr. Waldman Removes Vallecular Cyst Blocking Infant’s Airway

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On November 26, 2016, Patty gave birth to James, her third child. Unlike her previous deliveries, James was born very lethargic and needed oxygen right away. Within a few minutes, he appeared fine and was able to go home at five days old.

However, the next day, Patty and her husband noticed James seemed to be choking and coughing up a stringy mucus. After a visit to a nearby emergency room   and a checkup with James’ pediatrician, the infant appeared to have tracheomalacia, a condition affecting the windpipe’s (trachea’s) walls. Patty was told James would outgrow this and there was no cause for alarm.

Weeks passed and James’ condition had not improved and he stopped gaining weight. Patty grew increasingly concerned. “Every breath James took sounded like he was gasping for air,” Patty recalled. Then, at 6-weeks-old, he had another choking incident. This time Patty and her husband suctioned out the mucus to stop the attack. The very next day, Patty brought James back to see his pediatrician. He only gained 8 ounces since birth and his pediatrician could hear that James’ breathing was very strained. She immediately referred him to Dr. Erik Waldman, an ear, nose and throat specialist who met James and his family that day at Yale New Haven Children’s Hospital Emergency Department, New Haven.

Using an endoscope, a tube with a camera at its end, Dr. Waldman examined James’ airway. Within seconds, he saw a vallecular cyst blocking James’ airway. He recommended surgery right away. A vallecular cyst occurs in the area between the very back of the tongue and the epiglottis. It is present at birth and enlarges as it fills with mucus. Patty was relieved someone finally identified the problem, but also petrified her baby needed surgery. “It was very unsettling,” said Patty, but “Dr. Waldman was wonderful and so nice.”

After surgery, James was breathing much better. Dr. Waldman cautioned that James may require a second surgery if his epiglottis didn’t return to its normal position.

Three weeks later, Dr. Waldman gave the family excellent news. The epiglottis was in its normal position and James was fine. He continues to see Dr. Waldman for follow up every several months, but has shown great progress and is gaining weight steadily.