Laryngoceles: Concepts of Diagnosis and Management

Abstract

A laryngocele is an abnormal dilatation of the laryngeal saccule. It is a rare benign lesion of the larynx. Various modalities of treatment have been advocated for its management. We present our treatment results and outcomes of a series of cases of laryngoceles and discuss the concepts of their management. This study included patients with different laryngocele types. Patients with an internal laryngocele underwent endoscopic CO 2 laser resection, while those with a combined laryngocele underwent resection via a V-shaped lateral thyrotomy approach. Seven patients had an internal laryngocele, and 4 patients had a combined laryngocele. Hoarseness and neck swelling were the most common symptoms. The mean followup period was 8.5 months. None of the patients needed a tracheostomy either preoperatively or postoperatively, or had recurrence of laryngocele. We advocate the lateral thyrotomy approach for combined laryngoceles as it provides safe, precise, and complete resection under direct visualization via a single approach, while we favor the endoscopic laser approach for the internal ones as it allows resection of the entire lesion with minimal laryngeal trauma, less operative time, and a shorter hospital stay.

Systematic review of laryngocele and pyolaryngocele management in the age of robotic surgery

“…The combined approach involved internal endoscopic laser resection, with a variety of open surgical approaches including a midline transcervical incision or V-shaped lateral thyrotomy. 2 , 12 However, Martinez et al. 5 reported on two cases with combined-type laryngocele who were managed solely with endoscopic laser resection.…”

“…7,[9][10][11] Laryngocele was treated by thyrotomy. 2,12 However, Martinez et al 5 reported on two cases with combined-type laryngocele who were managed solely with endoscopic laser resection. There were no reported complications associated with either approach, and only one post-mortem death, secondary to airway obstruction due to a combined laryngocele.…”

“…Risk factors include congenital factors, increased laryngeal pressure, and mechanical obstruction. 2,3 Mechanical obstruction of the ventricle is particularly concerning, because it is often secondary to a malignant process. 1,2 Laryngoceles are typically filled with air; however, they can be filled with mucus if the neck becomes obstructed because of inflammation or mechanical obstruction.…”

“…2,3 Mechanical obstruction of the ventricle is particularly concerning, because it is often secondary to a malignant process. 1,2 Laryngoceles are typically filled with air; however, they can be filled with mucus if the neck becomes obstructed because of inflammation or mechanical obstruction. The dilated saccule can also become infected, forming a laryngopyocele, which can in turn cause significant laryngeal supraglottic edema and mechanical obstruction.…”

“… 2 Laryngoceles usually occur in men above 50 years of age, and most are unilateral and combined-type. 1 , 2 …”