Question
Diagnose the underlying disorder that appears on Valsalva maneuver (Photograph)
A. Cystic hygroma.
B. Laryngocoele.
C. Branchial Cyst.
D. Thyroglossal cyst.
Show Answer
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Correct Answer » B Explanation |
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Laryngocoele (Description: Congenital anomalous air sac communicating with cavity of larynx)
Neck Swelling
- Swelling appearing on Valsalva Maneuvre:
- The source of the content can be blood vessel (phlebectesia or abnormality of the jugular veins-appears as bluish swelling) or can be air from the airway (external laryngocoele).
- A soft cystic mass at the lateral side of the neck, which does not change with Valsalva manoeuver, includes pharyngeal pouch/pharyngocoele, branchial cyst, cystic hygroma or solid tumour.
- Thyroglossal Cyst appears as a midline swelling which moves on protrusion of tongue and swallowing
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.
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.
- External laryngocele presents as a reducible swelling in the neck which increases in size on coughing or performing valsalva
- 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.
