CO2 Laser Marsupialization for Internal and Combined Laryngocele

Abstract Introduction Laryngoceleisan air-filled dilatation of the laryngeal saccule that can be classified according to its extent (internal, external, or combined) and contents (laryngocele or laryngopyocele). To date, there is no consensus on the best treatment for laryngocele. Objective The present study aims to demonstrate for the first time the effectiveness of CO2 laser marsupialization for internal and combined laryngoceles. Methods A retrospective study was accomplished in our ENT Clinic of the University Hospital, from 2010 to today, recruiting patients according to strict criteria. All patients had internal or combined laryngocele/laryngopyocele treated with CO2 laser marsupialization. Results A total of 15 patients were enrolled for a total of 17 laryngoceles; 66.67% of the patients were males and the mean age was 54.4 (±14.12) years old. Internal laryngoceles accounted for 64.71% of the total, and only 7 cases were laryngopyoceles. At the 3-year follow-up, no signs of recurrence were found. Conclusion CO2 laser marsupialization is efficacious in the treatment of laryngocele or laryngopyocele, both internal and combined, in terms of efficiency, safety, and fast postoperative recovery, without need for tracheotomy or open surgery.

Cervicothoracic Thymic Cyst: An Unusual Presentation

Cervicothoracic thymic cysts are rare and difficult to diagnose preoperatively. We report a case of a cervicothoracic thymic cyst presenting as a lateral neck mass and mimicking a laryngocele in a 3-year-old boy and its definitive management.

Laringocele como diagnóstico diferencial de quiste tiroideo / Laryngocele as a differential diagnosis of a thyroid cyst

A cervical mass is a usual complaint within the clinical practice. Among possible causes, thyroid cysts and nodules are frequent findings. However, there are differential diagnoses that arise from neighboring structures, which can be difficult to assess. We report an 18 years old male presenting with a cervical mass, clinically and ecographically suggestive of a right thyroid cyst. Fine needle aspiration was negative for neoplastic cells. Within surgery a paratracheal lesion was identified and resected. The histological findings were compatible with a laryngocele. A laryngocele is an abnormal dilatation of the laryngeal sacule that can simulate a thyroid cyst. Computarized tomography and magnetic resonance are of great importance in its diagnosis, but sometimes is found within surgery or in the anatomopathologic study.

Las masas cervicales son un motivo de consulta usual dentro de la práctica clínica. Dentro de estas, los nódulos y quistes de origen tiroideo son hallazgos frecuentes. Aún así, existen diagnósticos diferenciales originados de estructuras vecinas a la glándula tiroides, cuyo diagnóstico inicial es difícil. Presentamos el caso de un varón de 18 años con una masa cervical derecha, clínica y ecográficamente sugerente de un quiste tiroideo. La punción-aspiración con aguja fina fue negativa para células neoplásicas. En el intraoperatorio se identificó una lesión paratraqueal derecha que fue resecada. El diagnóstico histológico fue compatible con un laringocele. El laringocele es una dilatación anormal del sáculo laríngeo que puede simular un quiste tiroideo. La tomografía computarizada y la resonancia magnética son de gran utilidad en su diagnóstico, pero en ocasiones éste se realiza en el intraoperatorio o mediante el estudio anatomopatológico.

Laringocele mixto manifestado como una tumoración cervical / Mixed laryngocele evidenced as a lump in the neck

El laringocele es una dilatación llena de aire del sáculo del ventrículo laríngeo originado por un aumento anormal del tamaño del sáculo. La mayoría son asintomáticos y unilaterales, resultando ser hallazgos casuales descubiertos en exploraciones realizadas por otra causa. En la última década ha adquirido una mayor importancia debido: al incremento de su diagnóstico por el uso de TAC, y su asociación con el cáncer de laringe; obligando a descartar una patología tumoral subyacente ante todo laringocele. A pesar de ser una patología laríngea infrecuente y benigna, puede llegar a ser potencialmente letal por el distress ocasionado.

A laryngocele is an air-filled dilatation of the saccule of the laryngeal ventricle originated by an abnormal increase in size of the saccule. Most of them are asymptomatic and unilateral incidental findings found in explorations performed for other reasons. It has become fairly relevant in the lastdecade due to the increased diagnosis by the use of CT scan and its relationship with laryngeal cáncer (well recognised by most authors). This has made it necessary to exclude an underlying neoplasic cause for any laryngocele. In spite of being an infrequent and benign disease it can be potentially lethal due to the associated disturbances.

Laringocele: uma causa de obstrução de vias aéreas superiores / Laryngocele: a cause of upper airway obstruction

Laringoceles são dilatações anormais do sáculo do ventrículo de Morgani da laringe, localizando-se entre a falsa prega vocal e a face interna da cartilagem tireóide. Relevância clínica é rara, sendo o achado de laringoceles assintomáticas em necropsia muito alto. Algumas vezes, pode se apresentar já como uma grande massa cervical, levando à obstrução de vias aéreas e necessitando de intervenção de urgência. Neste trabalho, os autores relatam um caso de laringocele levando à obstrução de vias aéreas superiores, necessitando de traqueostomia de urgência e fazem uma revisão da literatura sobre o tema. Complicações de laringocele incluem infecção (formação de piocele), aspiração de patógenos e subseqüente bronquite e pneumonia, infecção do espaço lateral da faringe (depois de ruptura) e obstrução de vias aéreas superiores, como no caso apresentado. A laringocele, apesar de ser uma doença benigna, é uma causa potencial de obstrução respiratória que pode ameaçar a vida do paciente. O correto diagnóstico e manejo adequado precoce podem evitar que situações de emergência, como a do paciente do caso relatado, levem à morte.

Laryngoceles are abnormal dilatations of the laryngeal saccule, which rises between the ventricular folds, the base of the epiglottis and the inner surface of the thyroid cartilage. Clinical symptoms are rare, and the find of asymptomatic laryngoceles in pathology studies are frequent. Sometimes it is presented as cervical swelling causing airway obstruction in need of emergency intervention. In this study, we report a case of upper airway obstruction due to laryngocele treated by emergency tracheotomy and we review of the literature. Laryngocele complications include infection (pyocele formation), pathogens aspirations with subsequent bronchitis and pneumonia and upper airway obstruction, as in the case reported. Despite being benign tumors, laryngoceles cause relevant airway obstruction. Correct diagnosis and proper treatment can preclude emergencies as it happened to our patient hereby reported.

Insuficiência respiratória aguda provocada por laringocele / Acute airway distress caused by giant laryngocele

A laringocele consiste em herniação da parede anterior do sáculo laríngeo. Essa formação habitualmente não causa sintomas, no entanto, disfagia e dispnéia podem surgir, principalmente quando volumosas. Apresentamos um caso de laringocele associado à dispnéia súbita, que necessitou de traqueostomia de urgência. O diagnóstico foi confirmado através da vídeo-laringoscopia e da tomografia computadorizada e o paciente foi submetido à ressecção cirúrgica, evoluindo sem seqüelas funcionais.

Laryngocele consists of herniation from the anterior wall of laryngeal saeccule. This disease habitually does not cause symptoms. However, dysphagia and dyspnea can appear, mainly when it is voluminous. We present a case of laryngocele associated to sudden dyspnea that needed urgent tracheotomy. The diagnosis was confirmed with videolaryngoscopy and computed tomography. The patient underwent surgical resection, and he did not present functional sequels.

Laringocele: aspecto ultra-sonográfico - relato de caso / External laryngocele: sonographic appearance - a case report

Laringoceles são lesões relativamente raras definidas como dilatações anômalas dos sáculos dos ventrículos laríngeos. A classificação usual divide a laringocele em interna, externa e combinada ou mista. Laringoceles internas são as que se localizam medialmente à cartilagem tireóidea e geralmente causam compressão nas bandas ventriculares levando a rouquidão e sintomas compressivos na via aérea. As externas se estendem através da membrana tireóidea, apresentando-se como massas cervicais, e as mistas são as que ocupam as duas regiões, podendo causar ambos os sintomas. O diagnóstico é geralmente feito por tomografia computadorizada e/ou laringoscopia. Apresentamos um caso de laringocele mista em que o diagnóstico foi sugerido no exame de ultra-sonografia, num paciente encaminhado com história de massa cervical.

Laryngoceles are fairly unusual diseases defined as anomalous saccular dilatation of the laryngeal ventricles. The usual classification divides laryngoceles into internal, external and mixed types. Internal laryngoceles are those located medially to the thyrohyoid membrane and usually compress the false vocal cords causing hoarseness or airway obstructive symptoms. External laryngoceles extend through the thyrohyoid membrane, presenting as cervical masses; and mixed laryngoceles present both the internal and external components with their respective symptoms. Diagnosis is usually defined by computed tomography and/or laryngoscopy. This is a report of a case of mixed laryngocele diagnosed by ultrasonography in a patient referred for investigation with a history of palpable cervical mass.

A Case of Bilateral Mixed Type Laryngocele / 대한이비인후과학회지

A laryngocele is an uncommon, air-filled dilatation of the laryngeal saccule or appendix of the laryngeal ventricle with an unclear etiology. This abnormality is generally classified into internal, external, or mixed type depending on their relationship to the thyrohyoid membrane. Many laryngoceles are asymptomatic and are discovered incidentally when radiographs of the neck or endolaryngeal examinations are performed for unrelated symptoms. We have experienced a case of bilateral mixed type laryngocele.