Laryngocele

An abnormal dilation of the laryngeal saccule

Laryngocele is a pathological condition characterized by an abnormal dilation of the laryngeal saccule, which is an air-filled sac that communicates with the laryngeal ventricle. This condition can present as a neck mass and may cause airway obstruction or voice changes.

Anatomy and Pathophysiology

The larynx is a complex structure located in the neck, responsible for voice production, breathing, and protecting the trachea against food aspiration. The laryngeal saccule is a small pouch that extends from the laryngeal ventricle, which is situated between the false and true vocal cords. A laryngocele occurs when this saccule becomes enlarged and filled with air or fluid.

Laryngoceles can be classified into three types:

• Internal laryngocele: Confined within the larynx, it may cause airway obstruction or voice changes.
• External laryngocele: Extends through the thyrohyoid membrane and presents as a neck mass.
• Combined laryngocele: Features both internal and external components.

Etiology

The exact cause of laryngocele formation is not well understood, but several factors may contribute:

• Increased intralaryngeal pressure, often seen in individuals who use their voice extensively, such as singers or wind instrument players.
• Congenital weakness of the laryngeal saccule.
• Obstruction of the saccule opening, leading to air trapping.

Clinical Presentation

Patients with a laryngocele may present with a variety of symptoms depending on the type and size of the laryngocele:

• Hoarseness or changes in voice quality.
• A visible or palpable neck mass, particularly with external laryngoceles.
• Respiratory distress or stridor if the airway is compromised.
• Dysphagia or difficulty swallowing.

Diagnosis

The diagnosis of a laryngocele is typically made through a combination of clinical examination and imaging studies.

• Laryngoscopy: Direct visualization of the larynx can reveal an internal laryngocele.
• Imaging: CT scan or MRI can help delineate the extent of the laryngocele and differentiate it from other neck masses.

Treatment

The management of laryngocele depends on the symptoms and the type of laryngocele:

• Observation: Small, asymptomatic laryngoceles may be monitored without intervention.
• Surgical excision: Symptomatic laryngoceles, particularly those causing airway obstruction or significant cosmetic concerns, are typically treated with surgical removal. This can be done via an external approach or endoscopically.

Prognosis

The prognosis for patients with laryngocele is generally good following appropriate treatment. Surgical intervention is usually successful in resolving symptoms and preventing recurrence.

Related pages

• Larynx
• Vocal cords
• Airway obstruction

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  Laryngocele

• Laryngocele