Lateral Thyrotomy Approach on the Paraglottic Space for Laryngocele Resection

Abstract

Objective: To report on the results of using a lateral thyrotomy approach on the paraglottic space to gain greater access for laryngocele resection under direct vision. Study Design: A 26-year prospective and retrospective study. The study was conducted on 10 adult patients (5 men and 5 women) who had laryngocele of varying size on the paraglottic space. Six of the patients had internal laryngocele and four had exteriorized laryngocele. Five laryngoceles were leftsided, three were right-sided, and two were bilateral. Methods: A V-shaped, full-thickness thyroid lamina resection with the triangle base at the superior border and the apex at a point midway of the thyroid lamina vertical extent was performed. Results: A V-shaped lateral thyrotomy made exposure to the paraglottic space possible for direct submucosal laryngocele dissection. This approach has presented no complications to date. Postoperative minor edema or hematoma was found in the aryepiglottic and ventricular folds, but this disappeared within a few days. There was no recurrence; the minimum follow-up was 1 year. Conclusion: The triangular lateral thyrotomy approach provided access to the paraglottic space and superb visibility for resection of laryngocele of any size under direct vision, thus avoiding recurrence, morbidity, and complications.

Treatment of Laryngoceles: What Is the Progress over the Last Two Decades?

“…Laryngoceles are categorized as internal (Figure 1) or combined (Figure 2) [11]. The formerly used classification into internal, external, and combined laryngoceles is being abandoned because purely external laryngoceles cannot exist, as laryngoceles originate at the laryngeal saccule.…”

Laryngoceles - presentations and management

“…Surgical excision through external approach is described as the only effective treatment for symptomatic and complicated laryngoceles [3,[12][13][14]. Conservative management is recommended for the asymptomatic ones.…”

Laryngocele: Experience at a Tertiary Care Hospital of Eastern India

“…This approach also offers less recurrence rate, minimal morbidity, and negligible complications. 4,11,29 Endoscopic excision with laser is the treatment of choice in patients with internal laryngocele. It needs less operative time and does minimal damage to endolarynx and vocal folds.…”

“…Mixed laryngocele is otherwise called as the laryngocele that is situated both medial and lateral to the thyrohyoid membrane. 3,4 Laryngocele is an unusual disease representing more than 20% of the true submucosal lesions of the larynx. 5 Larry, 6 a surgeon to Napoleon army, first described laryngocele in 1829.…”