Dysphagia with filling defect detected on a barium swallow
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An air filled sac is seen at the right paralaryngeal space connected to the laryngeal ventricle by a thin track. It displays mucosal enhancement likely from associated inflammation. Multiple deep cervical reactionary lymphadenopathies are seen.
Diagnosis: Internal laryngocele
Laryngocele is usually an acquired herniation of laryngeal mucosa secondary to an increase in intralaryngeal pressure. Risk factors include excessive cough, playing wind instruments or post inflammatory stenosis and obstruction.
Differentials to consider include; laryngeal cysts, thyroglossal cyst, 2nd branchial cleft cyst and abscess. The patient in the current case works as a musician and plays the trumpet.