Internal Laryngocele: Unusual onset in a 91-year-old female patient

Abstract

While internal laryngoceles rarely cause major clinical complaints, they may lead to airway obstruction and require emergency intervention on rare occasions. We report a 91-year-old patient who was referred to the Ear, Nose & Throat Clinic of the Policlinico Santa Maria alle Scotte, Siena, Italy, in 2017 due to recurrent episodes of severe dyspnoea. A flexible nasopharyngolaryngoscopic examination revealed an internal laryngocele of approximately 1.5 cm in diameter that moved up and down the glottic plane, occasionally invading the subglottic space during inspiration and impeding airflow. This caused cyanosis and dyspnoea so severe that an emergency tracheotomy was considered. Luckily, after considerable effort, the patient was able to cough, causing the mass to move above the vocal plane and allowing normal breathing. The laryngocele was subsequently removed via laryngomicrosurgery. Although the incidence of internal laryngoceles is quite rare, physicians should consider this potentially life-threatening condition among patients with dyspnoea.

Imaging Findings Related to the Valsalva Maneuver in Head and Neck Radiology

“…9 In some cases, an etiology for laryngoceles may not be found. 10 Because these are usually incidental, the role of imaging is often to exclude a malignant cause, such as laryngeal cancer causing a secondary laryngocele. Simple excision can be performed for symptomatic cases.…”

Laryngocele: Report of two rare cases and review of the literature

“…Imaging studies are critical for making a diagnosis, determining the type, location and extent of a laryngocele, and outlining the best treatment options. Despite the fact that it is a benign condition, a laryngocele may occasionally appear as an acute airway emergency and be threatening to patients' lives ( 6 ). The definitive surgical approach and tracheostomy depend on the type of laryngopyocele, its presentation and the patient's comorbidities.…”