Contents
Rare, cystic dilatation of the laryngeal saccule that may extend internally into the airway or externally through the thyrohyoid membrane.
- Virchow introduced the term laryngocele, in 1867, to describe an abnormal dilatation of the saccule forming an air sac.
Clinical features
Many laryngoceles are asymptomatic; sometimes, they may cause a cough, hoarseness, stridor, sore throat and may present as a swelling on one or both sides of the neck. Based on location, three types of laryngocele have been described.
Internal laryngocele:
Confined to interior of larynx and extends posterosuperiorly into the false vocal cord and the aryepiglottic fold
- Dysphonia, dyspnea, sore throat and globus pharyngeous with associated discomfort in the neck.
- Appears on laryngoscopy as a smooth swelling of the supraglottis.
External laryngocele:
Extends superiorly to appear laterally in the neck through the opening in the thyrohyoid membrane for the superior laryngeal nerve and vessels
- Clinically present as neck swelling at the level of the hyoid bone anterior to the sternocleidomastoid muscle.
Combined/mixed laryngocele:
Simultaneous existence of both internal and external features
Complications
- Laryngomucocele: Laryngocele obstructed and filled with mucous
- Laryngopyocele (10% cases): Secondarily infected laryngomucocele
- Presents as an airway obstruction and/or an infected neck mass.
- Associated with supraglottic squamous cell carcinoma
Diagnosis
Clinical diagnosis:
- Valsalva maneuver: Swelling becomes larger
- Bryce sign: Hissing sound on compression of swelling due to sudden gush of excess air into larynx
CT scan: Neck
M/important examination for correct diagnosis
Management
Surgical management:
Excision of the laryngocele can be performed by endoscopic and/or external or combined approach. The choice of the approach depends on the type and size of the laryngocele.
- External cervical approach
- Endoscopic laser treatment
