Laryngocele

LARYNGOCELE
  • Air filled cystic swelling due to dilation of saccule of the ventricle.
  • The saccule is a diverticulum of mucous membrane which starts from the anterior part of ventricular cavity and extends upwards between vestibular folds and lamina of thyroid cartilage.
  • The laryngoceles must be differentiated from saccular cyts; which is filled with mucous, and donot communicate with the laryngeal lumen. These saccular cysts are common in infants while laryngoceles are common in adults.
  • Differences between laryngocele and saccular cyst:

Laryngocele Saccular cyst
Filled with air Filled with mucous
Common in adults common in children
Sac communicates with laryngeal cavity Sac does not communicate with
laryngeal cavity
Types:
  • Laryngoceles can be classified into three types:
  • Internal - A laryngocele is defined as internal if the dilatation lies within the limits of the thyroid cartilage.
  • External - If the laryngocele extends beyond the thyroid cartilage and protrudes through the thyrohyoid membrane producing a lateral neck mass, it is considered external. Combined - In which both internal and external components are seen.
Causes
  • Due to raised transglottic air pressure as in trumpet players, glass blowers or weight lifters.
Clinical symptoms.
  • External laryngocele presents as a reducible swelling in the neck which increases in size on coughing or performing valsalva
  • Patient may present with hoarseness, cough, dyspnea, dysphagia or a foreign body sensation.
Management:
  • Internal laryngoceles can be removed through endoscopy.
  • External and combined internal and external laryngoceles can be managed through an open approach.
  • External and combined laryngoceles can be dissected via the thyrohyoid membrane .
Exam Question
  • Laryngocele arises from herniation through Thyrohyoid Membrane.
  • Laryngocele arises from Saccule of the Ventricle.
  • External laryngocele is a herniation that arises from Thyrohyoid Membrane.
  • An old man presented with hoarseness, cough, dysphagia, and foreign body sensation in the throat.
  • Laryngocele was suspected which arises from herniation through Thyrohyoid Membrane.
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