Objective A laryngocele is a space that develops as a result of pathological dilatation of the laryngeal saccule. However, the reported management of laryngoceles varies. We conducted a systematic review of the literature regarding the surgical management of laryngoceles and pyolaryngoceles, to understand the evolving nature of treatment for this rare condition. Methods We searched for publications in the PubMed, Cochrane Library, JBI Library of Systematic Reviews, and Ovid databases using the terms “laryngocele”, “pyolaryngocele”, and “laryngopyocele”, and reviewed the identified articles. Results After removal of repeated studies and filtering for relevance and studies written in English, a total of 227 studies were included in this review. No meta-analyses or randomized controlled trials have been published. The identified studies have been summarized in 14 reviews conducted since 1946. The meta-analysis determined that endoscopy was the preferred approach for internal laryngoceles, while combined laryngoceles benefited from both internal and external surgical approaches. Conclusions Laryngocele management has progressed since its initial description, from open surgery to an endoscopic approach, and more recently to a robotic-assisted surgical approach. The uptake of robotic surgery as a possible treatment modality over the last decade shows much promise for the treatment of these conditions.
BACKGROUND
Adenoid cystic carcinoma (ACC) of the trachea is one of the most common primary tracheal tumours, second in prevalence only to squamous cell carcinoma (SCC). course of progression is indolent, the oncological characteristics of an ACC predispose these tumours to extensive submucosal and perineural spread.
OBJECTIVE
We have conducted a systematic review of the literature to assess the current state of surgical resection and reconstructive options in comparison to survival outcomes.
METHODS
A review of publication on PubMed, Cochrane Library, JBI Library of Systematic Reviews and Ovid databases was undertaken. Searches using the terms “adenoid cystic carcinoma”, “cylindroma”, “trachea” and “tracheobronchial tree” identified all relevant articles in the literature. All articles were reviewed and only those in the English language were included. Journal articles published between 1966 to 2019 were included.
RESULTS
Using the terms “adenoid cystic carcinoma”, “cylindroma”, “trachea” and “tracheobronchial tree”, 112 and 202 articles were found from Ovid Medline and PubMed respectively. No meta-analyses were found in the Cochrane Library. JBI Library of systematic reviews revealed no systematic reviews. Following removal of duplicated studies, identification of English only studies and an assessment of relevance, a total of 247 were included in the study.
CONCLUSIONS
Tracheal ACC is a difficult disease to manage and treatment, due to its late presentation and significant associated morbidity. It is a rare primary tracheal malignancy that often presents with no specific symptoms last for weeks to years. It is commonly misdiagnosed as other primary respiratory issues. Complete surgical resection will give the patient the best chance of survival or even cure.
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