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:

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 .