Hoarseness of voice, right lateral neck swelling.
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A sizable right laryngeal cystic lesion with supra and infra-hyoid location (namely at the laryngeal supra-glottic region) with its inferior aspect reaching the level of the laryngeal ventricle. Laterally, the lesion is seen extending outside the laryngeal cartilaginous framework through the thyrohyoid membrane. The lesion displayed near water density with enhancing rim of uniform thickness.
The laryngeal component of the lesion is seen compressing the right aryepiglottic fold, pyriform sinus and extend anteriorly to the peri-epiglottic space, while the extra-laryngeal part is seen insinuating itself between the right submandibular gland (which is displaced anteriorly) and the ventral surface of the sternomastoid muscle.
The imaging features are consistent with a mixed laryngocele (both internal and external components). It is typically seen as a well defined, air or fluid-filled lesion related to the paraglottic space, which has continuity with the laryngeal ventricle. It is classified according to its extension into internal, external and mixed types. Surgical excision may become necessary if the laryngocele is symptomatic.