Afiadigwe EE¹*, Ugwu JO², Umeh US¹, Chukwuanukwu TOG³, Menkiti FE⁴and Obidike Afam Ben⁵

¹Department of ENT, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria
²Paediatric Surgery Unit, Department of Surgery, NAUTH, Nnewi, Anambra State, Nigeria
³Plastic Surgery Unit, Department of Surgery, NAUTH, Nnewi, Anambra State, Nigeria
⁴Department of Morbid Anatomy and Forensic Medicine, NAUTH, Nnewi, Anambra State, Nigeria
⁵Department of Anaesthesiology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

*Corresponding Author: Afiadigwe EE, Department of ENT, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria.

Received: April 13, 2022; Published: May 04, 2022

Abstract

Background: Cystic hygromas are benign congenital malformations of the lymphatic system resulting to abnormal dilatation of the lymphatic vessel. It is commonly located in the head and neck region with potential for local and systemic complications particularly those encasing and compressing vital structures.

Case Report: A three-year-old male who presented at the emergency room with a two weeks history of difficulty in breathing and progressively increasing right sided neck mass noticed after birth with associated fever, dyspnea, cough, nasal discharge and dysphagia to solids. He had a huge right sided neck mass measuring about 10x14 cm in diameter, fluctuant, warm to touch, non-tender and transilluminates well. The right lateral wall of the oropharynx was bulging and communicated with the mass. Radiological studies revealed a neck mass with marked compression and lateral deviation of the trachea, retropharyngeal extension with medial displacement of common carotid artery and internal jugular vein. He had emergency tracheostomy to relieve upper airway obstruction and was commenced on broad spectrum antibiotics, anti-inflammatory and antipyretics. He subsequently had an elective complete excision of the cystic sac which was found to be passing through and around the carotid sheath, encapsulating the internal jugular vein, separating it from the common carotid artery and vagus nerve.

Conclusion: Cystic hygroma when neglected can lead to severe complications with attendant increase for morbidity and mortality. Complete surgical excision when possible is the recommended modality of treatment with the lowest chances of recurrence. In so doing, extreme care including multidisciplinary collaboration should be undertaken to preserve the surrounding vital structures.

Keywords: Cystic Hygroma; Lymphatic Malformations; Surgical Excision; Carotid Sheath

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Citation

Citation: Afiadigwe EE., et al. “Giant Cystic Hygroma Encapsulating the Internal Jugular Vein and Causing Severe Airway Obstruction: A Rare Presentation and Review of Literatures".Acta Scientific Otolaryngology 4.6 (2022): 03-07.

Copyright

Copyright: © 2022 Afiadigwe EE., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.