UNASSIGNED: Pyolaryngocele is a very rare and serious complication of laryngocoele. The clinical presentation can be extremely severe acute epiglottitis with laryngeal dyspnea and major dysphagia. The treatment of choice is surgical excision. Our aim is to attract the intention of the surgeon to this unusual entity and describe its clinical features.
METHODS: We report a case of a 70-year-old male patient with a five-day history of left neck swelling, sore throat, and low-grade fever. An urgent CT scan showed a mixed pyolaryngocele. The management consisted of high-dose antibiotics and excision of the residual laryngocoele via an external approach.
UNASSIGNED: A pyolaryngocele is an unusual complication of laryngocoele that becomes secondarily infected causing serious symptoms. The management consists of administrating broad-spectrum antibiotics and aspiration of purulent material to decompress the sac. At a later stage, after relieving the acute symptoms we performed an external approach with formal excision of the laryngocele.
CONCLUSIONS: Pyolaryngocele is a rare complication of laryngocele and can present with serious complaints like dyspnea and sepsis. Excision of the laryngocoele is still the best treatment option to prevent this complication and recurrence.

Laryngocele is a rare clinical condition characterized by an abnormal dilation of the laryngeal saccule. The present study focused on two separate cases of diagnosed patients. The first patient suffered from internal laryngocele and complained of hoarseness for almost 1 year. Plasma was used to treat the internal laryngocele and the outcomes were satisfying. The patient did not undergo any tracheostomy due to previous endoscopic surgery. The second patient included in the present study was diagnosed with mixed laryngocele and complained of swelling on the left side of the upper aspect of the neck with considerable pain for >1 month. The patient was prepped for excision by an external transcervical technique under general anesthesia. None of the two patients had any recurrence or other changes during follow-up. The purpose of reporting these two cases of laryngocele was to increase awareness of this condition. Surgery is still the first-line treatment for diagnosed cases, but with the advent of new microscopic techniques, the use of plasma in an inter-pharynx setting has become more common. The results observed after using plasma to treat one internal laryngocele may be relevant to better understanding the application of this method and confirm that it may be a new suitable approach to treat this condition.

Introduction  Laryngocele is an 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.

Laryngocele is very uncommon and no consensus regarding its surgical management is yet established. While traditional external approach is still being recommended some suggest a better microlaryngoscopic management assisted by CO2 laser that has gained popularity. Recurrence is better known with conservative surgery but this paper presents a modified single stage endolaryngeal technique for combined laryngoceles to overcome the same. The salient features are (1) A comparatively larger operculum is created and all the visible mucosa is excised; (2) the base of residual postoperative cavity is moistened with cotton soaked with concentrated carbolic acid for 1 min and (3) the residual \'charred\' base with intermittent oozing is packed with single layer of surgicel. The reader is further encouraged to see surgical video of entire procedure.

Laryngoceles are rare dilated laryngeal saccules that can present as acute airway obstruction and lead to airway emergencies. A man, presented to the emergency room, with difficulty in breathing and change in voice. An unevaluated pulsatile swelling was present on the left side of neck. Since, the patient was in stridor, an awake fiberoptic bronchoscopy (FOB)-guided intubation was planned with readiness for emergency tracheostomy, if needed. On FOB, an edematous supraglottic area with a narrowed glottic opening was observed. The procedure was abandoned and a surgical tracheostomy was performed to secure the airway. Postoperative contrast-enhanced CT neck revealed a huge laryngocele in left cervical region. We recommend that a high index of suspicion for presence of laryngocele should be kept in mind when a patient presents with stridor with pulsatile neck swelling. Timely aspiration of laryngocele may help in amelioration of the respiratory distress avoiding emergency tracheostomy.

Laryngocele is defined as a dilation of the laryngeal saccule forming an air sac. Some differential diagnoses for laryngocele have been reported. The aim of the present paper was to describe a case of a patient referred for the evaluation a suspected thyroid nodule that was subsequently diagnosed as a mixed laryngocele. A 31-year-old male with no clinical manifestations was referred by an endocrinologist to undergo Doppler ultrasonography and fine-needle aspiration biopsy due to a preliminary ultrasonographic diagnosis of a nodule apparently in the thyroid. The diagnosis of laryngocele was raised considering the cytopathological analysis and imaging exam. Computed tomography of the neck confirmed this hypothesis. The patient was counseled to consult a surgeon, but, up to the end of this report, continued asymptomatic and in follow-up. We report a mixed laryngocele with different clinical behavior, showing that laryngocele may appear to be another entity and drawing the attention of clinicians to imaging similarities.

Chondrosarcoma of the thyroid cartilage is a sporadic disease with nonspecific clinical presentation. Smooth swelling of the supraglottic area should arouse suspicion of possible pathology. In addition to laryngoceles, which usually do not have a significant impact, otolaryngologists should consider chondrosarcoma of the thyroid cartilage and indicate computed tomography (CT). Late diagnosis leads to worse prognosis, particularly worse voice after more extensive surgery, need for tracheostomy, and worse survival from higher degree chondrosarcomas.

Laryngoceles are best treated with surgery. The goal of this study is to compare patient outcomes and complications in patients undergoing removal of laryngoceles with either transoral endoscopic/microlaryngoscopic or robotic approaches. A systematic review of the published literature was conducted using Pubmed, Web of Science, and the Cochrane Clinical Trials databases. A pooled analysis of individual data was used to compare outcomes between robotic and endoscopic approaches. A total of 30 studies were included. Nine studies with 95 patients were included in the final analysis. Eighty-one (85.26%) were treated with microlaryngoscopic surgery and 14 (14.74%) were treated with robotic-assisted surgery. The rates of tracheostomy (RR = 1.44, 95% CI = 0.389-5.332), complications (RR = 0.329, 95% CI = 0.047-2.294) and recurrence (RR = 0.354, 95% CI = 0.021-5.897) were not statistically different between groups. Within the endoscopic subgroup, 66 laryngoceles (78.57%) were completely excised, while 18 (21.43%) laryngoceles were treated with marsupialization. Marsupialization was associated with an increased risk of recurrence (RR = 4.889, 95% CI = 1.202-19.891). In the robotic subgroup, there was an increased risk of nasogastric tube use (RR = 103.867, 95% CI = 6.379-1619.214) and a longer mean length of hospital stay (p = 0.0001). Transoral treatment of laryngoceles has complication and recurrence rates of 18.95% and 7.37%, respectively. Robotic approaches are associated with higher rates of NGT use and increased hospital stay, however much of this is due to one robotic surgeon\'s preference for routine NGT placement and higher rates of combined laryngocele removal via robotic approach. Complete excision of combined laryngoceles is possible with transoral approaches. Marsupialization, reported in traditional endoscopic approaches, is associated with a significantly higher rate of recurrence (22.22% vs. 4.76%).

暂无摘要。

Laryngocele is an uncommon benign cystic dilatation of the laryngeal saccule that communicates with the laryngeal lumen and contains air. On the basis of its localization, it can be traditionally classified in internal, external, or mixed. Usually unilateral and rarely bilateral, it may be congenital or acquired. It most often appears later in life without important symptoms except for cervical swelling. Here, together with a review of literature, we report the case of a 72-year-old man, smoker but without other specific risk factors, who presented laryngeal dyspnea for about one year. Neck CT scan performed during a previous hospitalization for respiratory failure revealed a left mixed laryngocele that was later surgically removed with cervicotomic access. The patient was discharged after one week. One month after surgery, we confirmed the absence of disease with video laryngoscopy.