Mixed laryngocele

Case contributed by Dr Mostafa El-Feky

Presentation

Hoarseness of voice, right lateral neck swelling.

Patient Data

Age: 40 years
Gender: Male
CT

Neck

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.

Case Discussion

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.

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Case information

rID: 58819
Published: 13th Aug 2018
Last edited: 2nd Jun 2019
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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