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

Abstract

Objectives. To review surgical techniques used in the treatment of laryngoceles over the last two decades and point out developments and trends. Materials and Methods. PubMed, the Cochrane Library, and the JBI Library of Systematic Reviews were searched using the term “laryngocele.” Demographic data, type of laryngocele, presence of a laryngopyocele, type of treatment and need for a tracheotomy were assessed. Results. Overall, data on 86 patients were analyzed, culled from 50 articles, of which 41 were case reports and 9 were case series. No single systematic review or meta-analysis or randomized controlled trial has been published on the topic. Altogether, 71 laryngoceles in 63 patients met the criteria for further analysis focusing on surgical treatment. An external approach was selected in 25/29 (86.2%) cases of combined laryngoceles. Microlaryngoscopic resection using a CO2 laser was performed in three cases and endoscopic robotic surgery in one case. The majority of patients with an internal laryngocele, 31/42 (73.8%), were treated using the microlaryngoscopy approach. Conclusions. Microlaryngoscopy involving the use of a CO2 laser has become the main therapeutic procedure for the treatment of internal laryngoceles during the past 20 years. An external approach still remains the main therapeutic approach for the treatment of combined laryngoceles.

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

“…In fact, even though laryngocele surgeries are usually elective, the current patient required urgent management due to the extreme severity of her dyspnoea, for which an emergency tracheotomy was considered. 8 Imaging is essential for the diagnosis of a laryngocele. Overall, CT scans are the most effective method to determine the type, location and extent of the laryngocele and…”

“…a laryngofissure or lateral thyroidotomy) or a combined approach. 2,8 Recently, transoral robotic surgery has been reported to reduce morbidity and preserve the glottic space and vocal function, even for combined laryngoceles extending deep within the neck. 15 Moreover, this type of surgery has been found to be superior to classical methods in terms of safety, technical feasibility and curative effectiveness, in part because of the absence of skin incisions.…”

Musical Instrument-Associated Health Issues and Their Management

“…However, the playing of wind instruments has been identified as a risk factor of laryngocele development (Stell andMaran 1975, Prasad et al 2008). Most laryngoceles occur unilaterally (87.3%) (Zelenik et al 2014). Laryngoceles are categorized as either an internal type (accounting for 59% of all cases) if they are confined within the larynx or a combined type (accounting for 41% of all cases) if they extend externally through the thyrohyoid membrane (Zelenik et al 2014).…”

“…Most laryngoceles occur unilaterally (87.3%) (Zelenik et al 2014). Laryngoceles are categorized as either an internal type (accounting for 59% of all cases) if they are confined within the larynx or a combined type (accounting for 41% of all cases) if they extend externally through the thyrohyoid membrane (Zelenik et al 2014). Common symptoms include hoarseness (internal type) or a soft, reducible upper neck mass that increases in size with the Valsalva maneuver (combined type).…”

“…However, laryngoceles can also be incidentally detected in asymptomatic patients who undergo neck CT scanning or nasopharyngeal fiberscopic examination. Physicians should note that approximately 10% of laryngoceles present as airway emergencies (Zelenik et al 2014), and emergent extirpation of a laryngocele with or without tracheostomy may be necessary, especially in case of patients with large internal laryngoceles.…”