Hi Drs. I have been diagnosed with a mucosal retention cyst on my arytenoid process. I know it has been there at least 1.5 yrs (I could feel it when breathing hard – it restricted my breathing) but I just had it checked out recently. The CAT scan showed it was @1.1 cm in diameter. My Dr. says I should have it removed and that it is a “simple” procedure. I am most worried about the general anesthesia and possible damage to my teeth or trachea or wherever else the breathing tube goes. So 2 questions: 1) Do you think I should get a 2nd opinion? and 2), are these cysts ever aspirated instead of cut out? Thanks you so much for your thoughts-
The arytenoids are paired cartilages that attach to the back of the vocal cords. By moving the arytenoids, we move the vocal cords- apart for breathing and together for speaking. While there can be a cyst (mucous containing sac) on an arytenoid- one more commonly sees granulomas- which are areas of inflammation. Granulomas usually come from reflux- and treatment for reflux will often get these to resolve without intervention. Cysts come from tissue getting filled with mucous from one of the many many mucous secreting tiny glands throughout the airway. Usually after some type of trauma to the tissues- swallowing the wrong way, acid reflux or some other unknown cause.
While cysts can be tumors or even cancers, this one clearly is felt to be nothing worrisome. If there is a question of there being a tumor or cancer, clearly one should have it removed.
Otherwise, I would suggest removing this should it be growing or causing symptoms- such as hoarseness, difficulty breathing or discomfort. Removing the cyst is a relatively easy, quick, simple procedure and can be done by most Ear Nose and Throat surgeons- or by a Laryngologist (subspecialist in voice) It almost always is done with general anesthesia- and the risks are basically as you describe- but they are quite rare-
Removing the cyst involves taking the top off, so that it drains and heals open. Usually, this would take a couple of minutes, total. There is no advantage to to aspirating (suctioning out the cyst) as it is likely to refill- and is not really much less of a procedure.
In general, it never hurts to get another opinion…
I hope this helps clear things up.
Robert Pincus MD
Associate Professor Otolaryngology
NY Otolaryngology Group/ NY Voice Center