Treatment of combined laryngocele using an endoscopic approach – a case report
Authors:
M. Zábrodský; J. Plzák; Markéta Bonaventurová
Authors‘ workplace:
Klinika otorinolaryngologie a chirurgie hlavy a krku 1. LF UK a FN v Motole, Praha
Published in:
Otorinolaryngol Foniatr, 72, 2023, No. 4, pp. 215-220.
Category:
Case Reports
doi:
https://doi.org/10.48095/ccorl2023215
Overview
Laryngocele is a rare benign disease of the larynx that originates from dilating the laryngeal ventricles. The laryngocele communicates with the laryngeal lumen and so is filled with air. In case of closure, there can be an accumulation of pathological secret presented – mucus (laryngomucocele) and, in case of infection, the pus (laryngopyocele). We distinguish internal or combined laryngocele with the borderline of the thyrohyoid membrane. Clinical features dominate hoarseness, cough, dysphagia, foreign body sensation, and possibly dyspnea or neck mass. It can also be an incidental finding in imaging methods that are being done for other reasons. CT or MRI scans are fundamental in the diagnostic process because the clinical symptoms are not distinctive. The optimal treatment modality is surgery. An endoscopic approach is mainly used for the internal laryngoceles, and the external approach for the combined ones. Nevertheless, in the last few years, several works have been published concerning the use of the endoscope for the resolution, even in combined lesions. Most recently, also the use of transoral robotic surgery has gained popularity. We present the case of a 36-year-old patient who was taken to the local hospital for acute respiratory distress and must undergo an urgent tracheostomy. After the final diagnosis of large combined laryngomucocele was made, he was admitted to the tertiary hospital for definitive surgical treatment. The complete resection was made using the endoscope, and the patient was successfully freed from the tracheostomy tube.
Keywords:
laryngomucocele – minimally-invasive surgery – neck mass
Sources
1. Keim WF, Livingstone RG. Internal laryngocele. Ann Otol Rhinol Laryngol 1951; 60 (1): 39–50. Doi: 10.1177/000348945106000103.
2. Burke EN, Golden JL. External ventricular laryngocele. Am J Roentgenol Radium Ther Nucl Med 1958; 80 (1): 49–53.
3. Mobashir MK, Basha WM, Mohamed AE et al. Laryngoceles: Concepts of diagnosis and management. Ear Nose Throat J 2017; 96 (3): 133–138. Doi: 10.1177/014556131709600313.
4. Kántor P, Zeleník K, Komínek P. Laryngokély – současný pohled na problematiku. Prakt Lek 2020; 100 (4): 164–168.
5. Stell PM, Maran AG. Laryngocoele. J Laryngol Otol 1975; 89 (9): 915–924. Doi: 10.1017/s0022 215100081196.
6. Slonimsky E, Goldenberg D, Hwang G et al. A Comprehensive Update of the Incidence and Demographics of Laryngoceles in Adults. Ann Otol Rhinol Laryngol 2022; 131 (10): 1078–1084. Doi: 10.1177/00034894211055336.
7. Zelenik K, Stanikova L, Smatanova K et al. Treatment of Laryngoceles: what is the progress over the last two decades? Biomed Res Int 2014; 2014: 819453. Doi: 10.1155/2014/819453.
8. Thome R, Thome DC, De La Cortina RA. Lateral thyrotomy approach on the paraglottic space for laryngocele resection. Laryngoscope 2000; 110 (3 Pt 1): 447–450. Doi: 10.1097/000 05537-200003000-00023.
9. Amin M, Maran AG. The aetiology of laryn gocoele. Clin Otolaryngol Allied Sci 1988; 13 (4): 267–272. Doi: 10.1111/j.1365-2273.1988.tb01130.x.
10. Macfie DD. Asymptomatic laryngoceles in wind-instrument bandsmen. Arch Otolaryngol 1966; 83 (3): 270–275. Doi: 10.1001/archotol. 1966.00760020272018.
11. Juneja R, Arora N, Meher R et al. Laryngocele: A Rare Case Report and Review of Literature. Indian J Otolaryngol Head Neck Surg 2019; 71 (Suppl 1): 147–151. Doi: 10.1007/s12 070-017-1162-x.
12. Biswas S, Saran M. Blunt Trauma to the Neck Presenting as Dysphonia and Dysphagia in a Healthy Young Woman; A Rare Case of Traumatic Laryngocele. Bull Emerg Trauma 2020; 8 (2): 129–131. Doi: 10.30476/BEAT.2020.46455.
13. Chu L, Gussack GS, Orr JB et al. Neonatal laryngoceles. A cause for airway obstruction. Arch Otolaryngol Head Neck Surg 1994; 120 (4): 454–458. Doi: 10.1001/archotol.1994.01880280082016.
14. Slonimsky G, Hawng G, Goldenberg D et al. Terminology, Definitions, and Classification in the Imaging of Laryngoceles. Curr Probl Dia gn Radiol 2021; 50 (3): 384–388. Doi: 10.1067/j.cpradiol.2020.06.002.
15. Sádovská K, Binková H, Gál B. Laryngokéla – kazuistika. Otorinolaryngol Foniatr 2016; 65 (2): 150–151.
16. van Vierzen PB, Joosten FB, Manni JJ. Sonographic, MR and CT findings in a large laryngocele: a case report. Eur J Radiol 1994; 18 (1): 45–47. Doi: 10.1016/0720-048x (94) 90365-4.
17. Alvi A, Weissman J, Myssiorek D et al. Computed tomographic and magnetic resonance imaging characteristics of laryngocele and its variants. Am J Otolaryngol 1998; 19 (4): 251–256. Doi: 10.1016/s0196-0709 (98) 90127-2.
18. Micheau C, Luboinski B, Lanchi P et al. Relationship between laryngoceles and laryngeal carcinomas. Laryngoscope 1978; 88 (4): 680–688. Doi: 10.1002/lary.1978.88.4.680.
19. Harney M, Patil N, Walsh R et al. Laryngocele and squamous cell carcinoma of the larynx. J Laryngol Otol 2001; 115 (7): 590–592. Doi: 10.1258/0022215011908333.
20. Svejdova A, Kalfert D, Skoloudik L et al. Oncocytic papillary cystadenoma of the larynx: comparative study of ten cases and review of the literature. Eur Arch Otorhinolaryngol 2021; 278 (9): 3381–3386. Doi: 10.1007/s00405-021-06841-2.
21. Purnell PR, Haught E, Turner MT. Minimally invasive treatment of laryngoceles: a systematic review and pooled analysis. J Robot Surg 2022; 16 (1): 1-14. Doi: 10.1007/s11701-021-01210-x.
22. Martinez Devesa P, Ghufoor K, Lloyd S et al. Endoscopic CO2 laser management of laryngocele. Laryngoscope 2002; 112 (8 Pt 1): 1426-1430. Doi: 10.1097/00005537-200208000-00018.
23. Szymanowski AR, Fechtner L, Muscarella J. Endoscopic Excision of a Large Combined Laryngocele. Ear Nose Throat J 2020; 99 (5): NP50–NP51. Doi: 10.1177/0145561319840142.
24. Al-Yahya SN, Baki MM, Saad SM et al. Laryngopyocele: report of a rare case and systematic review. Ann Saudi Med 2016; 36 (4): 292–297. Doi: 10.5144/0256-4947.2016.292.
25. Bisogno A, Cavaliere M, Scarpa A et al. Left mixed laryngocele in absence of risk factors: A case report and review of literature. Ann Med Surg (Lond) 2020; 60: 356–359. Doi: 10.1016/ j.amsu.2020.11.024.
26. Ciabatti PG, Burali G, D‘Ascanio L. Transoral robotic surgery for large mixed laryngocoele. J Laryngol Otol 2013; 127 (4): 435–437. Doi: 10.1017/S0022215113000236.
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2023 Issue 4
Most read in this issue
- Vertigo with sudden hearing loss and eye symptoms – Cogan‘s syndrome
- Current trends in the management of patients with cleft lip and cleft palate
- Surgical treatment and recurrence of preauricular sinus over a 15-year period at the Clinic of Children Otorhinolaryngology of the MFCU and the NICD in Bratislava
- Hyaluronic acid and its importance and possibilities of use in otorhinolaryngology