LARYNGOCELE
Definition: These are air filled cystic swellings due to dilatation of the saccule lined by columnar ciliated epithelium.
Types:
A laryngocele may be:
- Internal which is confined within the larynx and presents as distension of false cord and aryepiglottic fold.
- External in which distended saccule herniates through the thyroid membrane and presents in neck.
- Combined or mixed in which both internal and external components are seen
Aetiology:
It is supposed to arise from raised transglottic air pressure
- Seen in professional trumpet players, glass blowers.
- Persons having chronic cough and asthma.
- A laryngocele in an adult may be associated with carcinoma which causes obstruction of saccule.
Clinical features:
- Swelling in the neck which reduces on pressure and increases on Valsalva manoeuvre.
- Hoarseness of voice with normal vocal cords.
- Sudden onset stridor.
- Dysphagia with halitosis.
- Snoring.
- Pain.
- Coughing.
- Boyce sign– Gurgling sound on compressing the external laryngocele with reduction of swelling.
- Pyocoele formation can be a sequelae.
Investigations:
- Plain X-ray neck shows an air-filled sac.
- CT scan neck shows the extent and origin of the laryngocele. Both the above investigations are done with and without Valsalva’s manoeuvre.
Treatment:
- Surgical treatment is advised only if patient is symptomatic or if the laryngocele is infected.
- Surgery aims at excising the saccule.
- Tracheotomy is done as an emergency in cases of stridor.
Surgery for Internal laryngocele includes:
- Transthyrohyoid membrane approach.
- V-shaped thyrotomy.
In Combined laryngocele:
External part is managed by
- Transthyrohyoid membrane approach.
- Thyrotomy with resection of the upper 1/3 thyroid cartilage.
- V-shaped thyrotomy.
Internal part is managed by
- Microlaryngoscopic CO2 laser resection.
- Endoscopic robotic surgery.
We Are Always Ready to Help You.
Book An Appointment
