Systematic review of laryngocele and pyolaryngocele management in the age of robotic surgery

Objective A laryngocele is a space that develops as a result of pathological dilatation of the laryngeal saccule. However, the reported management of laryngoceles varies. We conducted a systematic review of the literature regarding the surgical management of laryngoceles and pyolaryngoceles, to understand the evolving nature of treatment for this rare condition. Methods We searched for publications in the PubMed, Cochrane Library, JBI Library of Systematic Reviews, and Ovid databases using the terms “laryngocele”, “pyolaryngocele”, and “laryngopyocele”, and reviewed the identified articles. Results After removal of repeated studies and filtering for relevance and studies written in English, a total of 227 studies were included in this review. No meta-analyses or randomized controlled trials have been published. The identified studies have been summarized in 14 reviews conducted since 1946. The meta-analysis determined that endoscopy was the preferred approach for internal laryngoceles, while combined laryngoceles benefited from both internal and external surgical approaches. Conclusions Laryngocele management has progressed since its initial description, from open surgery to an endoscopic approach, and more recently to a robotic-assisted surgical approach. The uptake of robotic surgery as a possible treatment modality over the last decade shows much promise for the treatment of these conditions.

The case of laryngopyocele and acute respiratory disorder

Laryngocele is an air-filled or fluid-filled abnormal dilatation of laryngeal saccule. The paper presents the case of tracheotomy in acute respiratory disorder due to laryngopyocele in a 76-year old woman. The patient was complaining of swelling of the neck for 3 day before admitting to the hospital. The tracheotomy was performed to quickly secure an airway prior to progression of the swelling. Computed tomography examination showed the presence of a mixed-type laryngocele both sides - on the right air-filled and on the left fluid-filled. First the acute infection was treated with antibiotics and then the laryngopyocele was surgically removed from external approach. The tracheotomy removal was few days after surgery. A review of the literature is also presented.

Rare case of combined laryngocoele masquerading as laryngeal carcinoma: a case report and review of literature

<p>Laryngocoele is an abnormal dilatation of the laryngeal saccule. It is a rare entity. Patient generally presents with hoarseness, dysphagia, dyspnea, foreign body sensation in throat and swelling in the neck. It is a benign condition, however the risk of malignancy is always associated with it, especially, if a patient is smoker or tobacco chewer. Once the diagnosis is established, laryngocoele are best treated by surgery.<strong> </strong>We present a rare case of combined laryngocoele in a 62 year old male patient, a chronic smoker, with history of recurrent swelling in neck right side for 2 years and hoarseness for duration of 1 month. It was a diagnostic dilemma as to what we were dealing with, a benign condition or malignancy. Eventually patient underwent excision by external approach. Resected specimen histo-pathological examination was consistent with laryngocoele. Post excision his normal voice was also restored.</p>

Laryngoceles: Concepts of Diagnosis and Management

A laryngocele is an abnormal dilatation of the laryngeal saccule. It is a rare benign lesion of the larynx. Various modalities of treatment have been advocated for its management. We present our treatment results and outcomes of a series of cases of laryngoceles and discuss the concepts of their management. This study included patients with different laryngocele types. Patients with an internal laryngocele underwent endoscopic CO2 laser resection, while those with a combined laryngocele underwent resection via a V-shaped lateral thyrotomy approach. Seven patients had an internal laryngocele, and 4 patients had a combined laryngocele. Hoarseness and neck swelling were the most common symptoms. The mean follow-up period was 8.5 months. None of the patients needed a tracheostomy either preoperatively or postoperatively, or had recurrence of laryngocele. We advocate the lateral thyrotomy approach for combined laryngoceles as it provides safe, precise, and complete resection under direct visualization via a single approach, while we favor the endoscopic laser approach for the internal ones as it allows resection of the entire lesion with minimal laryngeal trauma, less operative time, and a shorter hospital stay.

A Giant Combined Laryngomucocele

ABSTRACT Laryngomucocele is a rare benign laryngeal disease characterized by cystic dilatation of laryngeal saccule with collection of mucous in it. The etiology behind its occurrence is still unclear, but congenital and acquired factors have been implicated in its development. Although it is a benign lesion, its presence in an old patient since many days should prompt the examiner to diligently search for laryngeal malignancy. We are presenting the case of a 61 years old male who presented with swelling in the neck, hoarseness of voice, dysphagia and dyspnea on exertion. The patient was thoroughly evaluated clinically, endoscopically and radiologically. He was diagnosed to be suffering from laryngomucocele and was managed by an external lateral cervical approach. How to cite this article Harkare VV, Dhote KS, Deosthale NV, Khadakkar SP, Dhoke PR, Singh BS. A Giant Combined Laryngomucocele. Int J Head Neck Surg 2014;5(1):45-47.

Saccular Cyst of Larynx

ABSTRACT A saccular cyst is a mucous-filled dilatation of the laryngeal saccule which can be congenital or acquired. The management of these cysts has changed over the period of time. An adult patient was presented with hoarseness of voice. Videolaryngoscopy showed a well-defined pedunculated mass. Endoscopic-guided excision of the cyst was done. Histopathology showed features of saccular cyst of larynx. Laryngeal saccular cyst should be excised to relieve voice change, respiratory obstruction and for possible carcinomatous change. This article aims at management of saccular cyst along with review of literature. How to cite this article Shantharam L, Somashekara KG, Priya NS. Saccular Cyst of Larynx. Int J Phonosurg Laryngol 2013;3(1):21-23.

Bilateral Mixed Laryngocele

ABSTRACT Laryngocele is a rare, benign dilatation of the laryngeal saccule that may extend internally into the airway or externally through the thyrohyoid membrane. The incidence of laryngocele is 1 per 2.5 million people per year. It may be asymptomatic or sometimes may present with cough, hoarseness, stridor, sore throat and as a swelling on one or both sides of the neck. We are reporting a case of bilateral mixed laryngocele in a 41 years old male, its clinical presentation and investigations along with a review of literature. How to cite this article Gupta R, Gupta S, Bhat A, Kalsotra P, Singh KP, Prakash O, Gupta S. Bilateral Mixed Laryngocele. Int J Phonosurg Laryngol 2013;3(2):69-72.