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Heuveling DA, Mahieu HF. Endoscopic CO 2 Laser Resection Using the Inversion Technique in 22 Combined Laryngoceles. Laryngoscope 2023; 133:2742-2746. [PMID: 37017240 DOI: 10.1002/lary.30687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/04/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVE To demonstrate the feasibility of transoral resection of, even large, combined laryngoceles by endoscopic CO2 laser resection using the inversion technique. METHODS 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. RESULTS 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. CONCLUSION 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. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2742-2746, 2023.
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Affiliation(s)
- Derrek A Heuveling
- Dept. of Otolaryngology, Meander Medical Center, Amersfoort, The Netherlands
| | - Hans F Mahieu
- Dept. of Otolaryngology, Meander Medical Center, Amersfoort, The Netherlands
- Ruysdael Voice Clinic, Amsterdam, The Netherlands
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Zhang J, Ma X, Li X, Song P, Wu Y. Laryngocele: Report of two rare cases and review of the literature. Exp Ther Med 2023; 26:424. [PMID: 37602305 PMCID: PMC10433409 DOI: 10.3892/etm.2023.12123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/22/2023] [Indexed: 08/22/2023] Open
Abstract
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.
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Affiliation(s)
- Jin Zhang
- Clinical Medical College of Jining Medical University, Jining, Shandong 272067, P.R. China
| | - Xu Ma
- Clinical Medical College of Jining Medical University, Jining, Shandong 272067, P.R. China
| | - Xiaoyu Li
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272007, P.R. China
| | - Panpan Song
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272007, P.R. China
| | - Yungang Wu
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272007, P.R. China
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Verro B, Saraniti C. CO2 Laser Marsupialization for Internal and Combined Laryngocele. Int Arch Otorhinolaryngol 2023; 27:e428-e434. [PMID: 37564468 PMCID: PMC10411063 DOI: 10.1055/s-0042-1748926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/20/2022] [Indexed: 08/12/2023] Open
Abstract
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.
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Affiliation(s)
- Barbara Verro
- ENT Clinic, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Carmelo Saraniti
- ENT Clinic, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo, Italy
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Slonimsky E, Goldenberg D, Hwang G, Gagnon E, Slonimsky G. A Comprehensive Update of the Incidence and Demographics of Laryngoceles in Adults. Ann Otol Rhinol Laryngol 2021; 131:1078-1084. [PMID: 34706568 DOI: 10.1177/00034894211055336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To provide updated data on the incidence, types, and demographics of laryngoceles in the adult population. METHODS We searched the medical archives of our institute for computed tomography (CT) studies acquired between January 1, 2007 and December 31, 2017 in which the term "laryngocele" appeared in the radiology reports. Two of the authors reviewed relevant images for the presence, type, distribution, and laterality of true laryngoceles. Demographic and clinical data were extracted from medical records and the incidence was calculated. RESULTS Laryngoceles were detected in 53 out of the 79 893 patients with relevant CT data, which equates to an incidence of 151 per 2.5 million (0.06:1000) patients per year. The male:female ratio was 3:1, average age was 60 (±18) years, and incidence peaked among patients in the sixth decade of life. Nine patients (17%) had known laryngeal cancer; however, the majority of the cohort did not have follow up clinic visits. CONCLUSION Our study demonstrates that the incidence of laryngoceles is much greater than previously reported. In most cases, the diagnosis of a laryngocele was an incidental radiological finding. Male gender predilection and age at presentation are in agreement with previous reports. Association of laryngoceles with laryngeal cancer could not be calculated due to low rates of follow ups. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Einat Slonimsky
- Department of Diagnostic Radiology, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - David Goldenberg
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Gloria Hwang
- College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Eric Gagnon
- Department of Diagnostic Radiology, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Guy Slonimsky
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Pennsylvania State University, Hershey, PA, USA
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Kara İ, Kökoğlu K, Çağlı S, Yüce İ. Bilateral Laryngocele Causing Epiglottic Deformity and Upper Airway Obstruction. Turk Arch Otorhinolaryngol 2019; 57:99-101. [PMID: 31360929 DOI: 10.5152/tao.2019.3949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/28/2019] [Indexed: 11/22/2022] Open
Abstract
Laryngocele is the cystic dilatation of laryngeal ventricle. Most cases are asymptomatic and incidentally diagnosed in radiologic examinations. Although the etiology is unclear, obstruction, laryngeal pressure, congenital defects are possible risk factors. Computed tomography is the best method for diagnosis. Endoscopic, external or combined approaches have been described in the surgical treatment. Laryngocele should be kept in mind in patients with acute upper airway obstruction. Such patients may require tracheostomy. Some patients with laryngocele can also have laryngeal cancer, in which case direct laryngoscopy must be performed. This report presents a case with respiratory distress associated with bilateral laryngocele, and his management in the light of the literature.
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Affiliation(s)
- İrfan Kara
- Department of Otorhinolaryngology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Kerem Kökoğlu
- Department of Otorhinolaryngology, Develi HMK State Hospital, Kayseri, Turkey
| | - Sedat Çağlı
- Department of Otorhinolaryngology, Erciyes University School of Medicine, Kayseri, Turkey
| | - İmdat Yüce
- Department of Otorhinolaryngology, Erciyes University School of Medicine, Kayseri, Turkey
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Kiricsi Á, Fazekas P, Nagy A, Tóbiás Z, Bella Z, Rovó L, Csanády M. [Surgical treatment of laryngocele]. Orv Hetil 2019; 160:1235-1240. [PMID: 31352810 DOI: 10.1556/650.2019.31447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Laryngocele is a unilateral or bilateral dilation of the saccule or appendix of the laryngeal ventricle. It is a benign lesion, often without any specific symptom, diagnosed unintentionally, but it can cause life-threatening airway obstruction, needing emergency tracheotomy. The authors present three cases of laryngocele and the related surgical methods. Orv Hetil. 2019; 160(31): 1235-1240.
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Affiliation(s)
- Ágnes Kiricsi
- Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 11., 7626
| | - Piroska Fazekas
- Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 11., 7626
| | - Attila Nagy
- Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 11., 7626
| | - Zoltán Tóbiás
- Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 11., 7626
| | - Zsolt Bella
- Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 11., 7626
| | - László Rovó
- Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 11., 7626
| | - Miklós Csanády
- Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 11., 7626
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Patel KB, Lin C, Kramer S, Fada C, Ozer E. Transoral robotic excision of laryngocele: Surgical considerations. Head Neck 2019; 41:1140-1143. [PMID: 30652374 DOI: 10.1002/hed.25612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 10/28/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transoral robotic surgery (TORS) has emerged as a novel, safe, and feasible procedure for the resection of malignant supraglottic laryngeal cancers. The purpose of this study was to demonstrate the surgical technique with extension of the use of TORS to excise a laryngeal cyst. RESULTS Laryngeal cyst resection, along with its tract, was accomplished with preservation of both false and true vocal cords. There was no perioperative or early postoperative complications. The patient was extubated immediately after surgery. Oral diet was initiated within 24 hours. No tracheostomy was required. A video demonstration of the surgical technique is included on Head & Neck's website. CONCLUSION TORS is a safe and feasible procedure for excision of selected laryngeal cysts.
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Affiliation(s)
- Krupal B Patel
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Chen Lin
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Scott Kramer
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Craig Fada
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Kim CM, Holliday MA, Newkirk KA. Laryngeal Pilar Cyst Masquerading as an Internal/External Laryngocele. Clin Med Insights Ear Nose Throat 2018; 11:1179550618815917. [PMID: 30574000 PMCID: PMC6299294 DOI: 10.1177/1179550618815917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022]
Abstract
Objectives: This study aimed to document and describe a case of a laryngeal pilar cyst and to review the literature. Methods: We describe the case of a 65-year-old woman with a laryngeal pilar cyst presenting with occasional ear pain and positional dyspnea, with imaging studies suggesting external/internal laryngocele. We also review the existing clinical literature. Results: Pilar cysts are adnexal skin lesions most commonly found in the scalp of elderly women. They generally have a benign course, but in rare instances single or multiple foci of proliferating cells can lead to the neoplastic formation of proliferating trichilemmal cysts, which carry malignant potential. Depending on the location of the cyst, pilar cysts may also present functional challenges for the patient. Conclusions: Herein, we describe a pilar cyst in and around the larynx appearing initially as a laryngocele. Pilar cysts may present surrounding the larynx and may be mistaken for a vast array of pathologies. It is important to keep the differential broad when evaluating laryngeal masses.
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Affiliation(s)
- Christine M Kim
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Michael A Holliday
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Abstract
Laryngocele is a rare entity and can be defined as an abnormal cystic dilatation of saccule of the laryngeal ventricle with communication to the lumen of larynx. Laryngopyocele is a rare complication of laryngocele when it is infected. Patients may present with fever, neck swelling, shortness of breath, and hoarseness. Acute presentation can develop rapidly with alarming symptom, such as stridor, which signifies airway obstruction and warrants immediate treatment and airway protection. Computed tomography and endoscopy are useful in making the diagnosis and delineate the severity of disease. Laryngopyocele should be treated with antibiotics, drainage of purulent content, and followed by definitive surgical excision.
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Affiliation(s)
- Sun Yu Lam
- Department of Radiology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - Hin Yue Lau
- Department of Radiology, Tuen Mun Hospital, Tuen Mun, Hong Kong
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Meng L, Zhang QF, Liu DL, Jin YF. [Bilateral laryngocele:a case report]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1739-1741. [PMID: 29871188 DOI: 10.13201/j.issn.1001-1781.2016.21.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Indexed: 11/12/2022]
Abstract
A 71 years old male with throat discomfort, shortness of breath, irritating cough admission. Fiberoptic laryngoscope: bilateral glottis ventricular zone with about quail egg size smooth cystic masses. Throat enhanced CT: infrahyoid margin level about bilateral aryepiglottic fold inside have package containing gas shadow, communicated with the laryngeal chamber. Support laryngoscope under coblation radiofrequency ablation assisted laryngeal cyst excision were done and postoperative pathology consistent with laryngocele.
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Lancella A, Abbate G, Dosdegani R. Mixed laryngocele: a case report and review of the literature. Acta Otorhinolaryngol Ital 2007; 27:255-257. [PMID: 18198756 PMCID: PMC2640037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 03/22/2007] [Indexed: 05/25/2023]
Abstract
Laryngocele is a rare, benign dilatation of the laryngeal saccule that may extend internally into the airway or externally through the thyrohyoid membrane. Many laryngoceles are asymptomatic; sometimes they may cause a cough, hoarseness, stridor, sore throat and may present as a swelling on one or both sides of the neck. Laryngocele may be associated with supraglottic squamous cell carcinoma. Computed tomography scan is the most effective imaging method for diagnosis. Surgery is the treatment of choice. A case of large mixed laryngocele in a 75-year-old male is described together with surgical management and followup. A review of the literature is also presented.
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Affiliation(s)
- A Lancella
- Otorhinolaryngology Unit, S. Biagio Hospital, Domodossola (VB), Italy.
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