Observations on the size of the saccule in laryngectomy specimens

Abstract

Over 300 instances of the association of laryngocele with laryngeal carcinoma have been reported in Europe, but only seven in North America. In the present study, 353 serially sectioned total laryngectomy specimens were examined and the saccule measured with a steel ruler. Saccules extending superior or posterior to the thyroid cartilage were considered as large. Larynges were classified as “cancer” or “normal,” the latter being uninvaded organs from patients with adjacent disease. Among the 242 cancer larynges, there were 43 specimens where the saccule exceeded thyroid cartilage dimensions, a laryngocele rate of 17.8%. Mean saccule height was significantly greater in cancer than in normal specimens in coronal sections (P=0.04), and mean saccule length was significantly greater in cancer than in normal specimens in horizontal sections (P=0.001). The incidence of large saccules showed a difference between cancer and normal larynges which was highly significant (P=0.0002).

Unilateral combined laryngocoele with recurrent respiratory papillomatosis: case report

“…These particular presentations are better explained by the second theory, which focuses on laryngeal physiology. According to this theory, any cause of persistently increased intralaryngeal pressure, such as coughing, changes in neuromuscular mechanics or changes in phonatory mechanics, predisposes patients to develop laryngocoeles 3 , 7 , 9 , 11 – 14 . This theory also supports the formation of laryngocoeles in wind instrument and trumpet players and glass blowers 5 , 15 .…”

“…1 They can occur with or without cancer; however, there is a higher incidence of laryngocoele in patients with carcinoma of the larynx, compared with controls. 3,7 The present case report demonstrates a unilateral combined laryngocoele occurring in conjunction with adultonset respiratory papillomata. There are currently two other documented cases of saccular pathology accompanying papilloma in the English literature.…”

“…Laryngocoeles present in only one out of 2.5 million patients per year 1 . They can occur with or without cancer; however, there is a higher incidence of laryngocoele in patients with carcinoma of the larynx, compared with controls 3 , 7 …”

A Rare Case of Laryngopyocele with Airway Obstruction

“…Laryngoceles are associated with laryngeal carcinoma, with the presence of ~18% of laryngocele in patients with laryngeal carcinoma. [ 7 8 9 10 11 ] Laryngopyocele occurs when the laryngocele is infected, usually found in the mixed type, with pathogens most commonly being Escherichia coli, Haemolytic Streptococcus B, Staphylococcus aureus , and Pseudomonas Aeruginosa .…”

The laryngeal saccule: Clinical significance

“…Burke and Golden (1958) defined a laryngocele as a saccule that extends beyond the superior border of the thyroid cartilage, but many physicians today recognize a symptomatic dilation of the saccule as a laryngocele even if the aforementioned criterion is not met (Mitroi et al,2011). There is a male predominance of the disease, and it is often seen in horn players or glassblowers (Birt,1987; Lancella et al,2007; Mitroi et al,2011). Internal laryngoceles are submucosal in nature and confined within the laryngeal cartilages, whereas external laryngoceles penetrate the thyrohyoid membrane to extend into the lateral neck.…”