To demonstrate the feasibility of transoral resection of, even large, combined laryngoceles by endoscopic CO2 laser resection using the inversion technique.
A retrospective study over a 25-year period of 20 patients with 22 combined laryngoceles. All patients were operated on using the CO2 laser inversion technique. Pre- and postoperative computed tomography (CT)-scans or magnetic resonance (MR) imaging were available in all patients.
There were no surgical problems during all procedures. One patient required a tracheotomy pre-operatively due to a compromised airway. All procedures were without intraoperative complications. Postoperatively, there were two complications: one hemorrhage, and one patient developed a granuloma with airway compromise. In two patients, residual disease was detected on postoperative imaging. One of them was re-operated several years later due to the progression of this residual external component of the laryngocele. One patient had a non-significant small internal laryngocele recurrence. The recurrence rate in this series was 2/22 (9.1%). The majority of patients (15/20) could be discharged from the hospital the day after surgery.
The results of this study show excellent control of combined laryngoceles using the CO2 laser inversion technique, with a short hospital stay and a low rate of complications and recurrence. Even in large combined laryngoceles, CO2 laser excision using the inversion technique should be considered.
4 Laryngoscope, 133:2742-2746, 2023.

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.

Laryngocele is a benign condition due to abnormal dilatation of the laryngeal saccule. Localized amyloidosis causing laryngocele is a rare entity with few reports in the literature. We present a young male patient with a large combined laryngocele secondary to laryngeal amyloidosis.