External Laryngocele a case report

History:

40 years old male patient came with c/o:

Swelling left side of neck - 5 years duration.

Its increase in size was progressive.

Sometimes it showed fluctuations in its size.

No h/o change in voice

No h/o breathlessness.

No h/o difficulty in swallowing.

Clinical photograph

On examination:

This patient had soft swelling measuring about 6 x 5 cms just below the angle of the jaw.

The mass was soft and compressible. No gurgling sound was heard on compression.

It showed a dramatic increase in size on valsalva maneuver.

X-ray soft tissue neck lateral view

CT scan axial view of neck: Showed air filled sac in the neck extending from the interior of larynx. Probable diagnosis "External laryngocele"

Discussion:

Laryngoceles are air filled sacs usually in continuity with laryngeal air column. This was first described by Virchow in 1863. These masses were said to be intimately related to the laryngeal ventricle. Usually they are in continuity with the ventricle. It is of three types:

1. Internal laryngocele - Confined to the interior of larynx

2. External laryngocle - This laryngocele prolapses through a rent in the thyrohyoid membrane and presents usually as a neck mass 3. Combined laryngocele - Both internal and external components of the laryngocele are seen in this type

These patients usually present with:

1. Hoarseness of voice

2. Breathlessness

3. Cough

4. Mass in the neck

Management:

This patient was taken up for surgery. Laryngocele was totally removed using external approach.