RESUMEN
Laryngeal air cyst (laryngocele) is a rare disease that is an abnormal cystic expansion of the deep structures of the laryngeal ventricle. They can be accompanied by serious complaints, such as shortness of breath, difficulty breathing during exercise, as well as at rest with large cysts. Computed tomography is the most effective method for determining the type, localization and degree of laryngocele. Although surgical treatment is considered the method of choice in cases of laryngeal air cyst, the approach significantly depends on the size of the lesion.
Asunto(s)
Laringocele , Tomografía Computarizada por Rayos X , Humanos , Quistes/cirugía , Quistes/diagnóstico , Enfermedades de la Laringe/cirugía , Enfermedades de la Laringe/diagnóstico , Enfermedades de la Laringe/fisiopatología , Laringocele/cirugía , Laringocele/diagnóstico , Laringoscopía/métodos , Laringe/cirugía , Laringe/diagnóstico por imagen , Laringe/fisiopatología , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
INTRODUCTION: We describe a first case of human congenital crico-thyroid dysplasia associated to a right sided aortic arch and an aberrant subclavian artery. CASE PRESENTATION: Our patient presented with a two-weeks history of acute dyspnea, and reported hoarseness since his childhood. An urgent tracheotomy was performed, followed by direct laryngoscopy. Endoscopic examination showed a deviation of the dorsoventral axis of the larynx, with an obstructive submucosal swelling the area of the right false cord and aryepiglottic fold. Computed tomography conducted the following day confirmed the crico-thyroid dysplasia, an infected laryngocele, and the presence of a right sided aortic arch and an aberrant subclavian artery. CONCLUSION: The embryological basis of these anomalies is attributed to congenital defects of the development of the fourth and sixth pharyngeal arches. To our knowledge, the congenital crico-thyroid dysplasia has not been previously reported in human. This case underscores the importance of recognizing anatomical variations in laryngeal cartilages, understanding their embryological origins, and potential associated malformations.
Asunto(s)
Arteria Subclavia , Humanos , Masculino , Arteria Subclavia/anomalías , Arteria Subclavia/diagnóstico por imagen , Cartílago Cricoides/diagnóstico por imagen , Cartílago Cricoides/anomalías , Laringoscopía , Tomografía Computarizada por Rayos X , Cartílago Tiroides/anomalías , Cartílago Tiroides/diagnóstico por imagen , Laringocele/diagnóstico por imagen , Laringocele/cirugía , Laringocele/diagnóstico , Laringocele/complicaciones , Traqueotomía , Anomalías CardiovascularesRESUMEN
Laringocele é a dilatação anormal do sáculo laríngeo, que se estende lateralmente às pregas vestibulares e mantém comunicação com o lúmen laríngeo. Não há consenso em relação às modalidades cirúrgicas para o tratamento. A utilização de laser no tratamento das lesões laringe permite ressecções com maior precisão e menor dano tecidual. Objetivo: apresentar série de casos de pacientes com diagnóstico de laringocele interna, submetidos a tratamento cirúrgico por abordagem transoral com laser de diodo. Método: realizado estudo descritivo e retrospectivo no Serviço de Otorrinolaringologia do Hospital do Servidor Público Municipal de São Paulo, no período de abril de 2021 a julho de 2023, de quatro pacientes com diagnóstico de laringocele interna que foram submetidos a tratamento cirúrgico por abordagem transoral com laser de diodo. Resultados: dos quatro pacientes, dois eram do sexo masculino e dois do sexo feminino, com idade que variou de 46 a 71 anos e com média etária de 63,2 anos. Todos foram diagnosticados com laringocele interna unilateral e submetidos a marsupialização da laringocele por abordagem transoral com laser de diodo. No seguimento pós-operatório não houve recorrências das laringoceles. Conclusão: nas laringoceles internas o tratamento cirúrgico pela via transoral tem se mostrado a melhor opção, pela menor morbimortalidade, menor tempo cirúrgico e menor tempo de internação. A abordagem transoral com o laser de diodo é uma alternativa ao laser de CO2, tendo sido observado nesta série de casos uma adequada hemostasia durante o procedimento cirúrgico. Palavras-chave: Laringocele. Laringopiocele. Terapêutica. Terapia a laser.
Asunto(s)
Láseres de Semiconductores/uso terapéutico , Laringocele/cirugía , Laringocele/diagnóstico , LaringoscopíaRESUMEN
Laryngoceles are rare dilated laryngeal saccules that can present as acute airway obstruction and lead to airway emergencies. A man, presented to the emergency room, with difficulty in breathing and change in voice. An unevaluated pulsatile swelling was present on the left side of neck. Since, the patient was in stridor, an awake fiberoptic bronchoscopy (FOB)-guided intubation was planned with readiness for emergency tracheostomy, if needed. On FOB, an edematous supraglottic area with a narrowed glottic opening was observed. The procedure was abandoned and a surgical tracheostomy was performed to secure the airway. Postoperative contrast-enhanced CT neck revealed a huge laryngocele in left cervical region. We recommend that a high index of suspicion for presence of laryngocele should be kept in mind when a patient presents with stridor with pulsatile neck swelling. Timely aspiration of laryngocele may help in amelioration of the respiratory distress avoiding emergency tracheostomy.
Asunto(s)
Obstrucción de las Vías Aéreas , Laringocele , Laringe , Obstrucción de las Vías Aéreas/diagnóstico , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Dilatación Patológica/cirugía , Humanos , Laringocele/diagnóstico , Laringocele/diagnóstico por imagen , Laringe/cirugía , Masculino , Tomografía Computarizada por Rayos XRESUMEN
Congenital laryngocele is an uncommon cause of neonatal stridor. There are only a few cases reported in the literature. The authors present a successfully treated case of an infant, whose life could only be saved by urgent tracheostomy. On the 5th postoperative day endoscopic excision and marsupialization provided patent airway. The patient could be decannulated. During follow-up no recurrence was observed.
Asunto(s)
Laringocele/diagnóstico , Ruidos Respiratorios/etiología , Disnea/etiología , Humanos , Recién Nacido , Laringocele/complicaciones , Laringocele/patología , Laringocele/cirugía , Laringoscopía , Imagen por Resonancia Magnética , MasculinoRESUMEN
Laryngopyocele is a rare complication involving the laryngocele which can present with acute airway compromise. A 31-year-old man presented with acute onset respiratory distress and dysphagia. He had swelling on either side of upper aspect of the neck with tenderness on left side. Videolaryngoscopy using 70° rigid Hopkins rod telescope showed a swelling in the left pyriform sinus pushing the ipsilateral vocal cord. However, glottic space was adequate. Contract-enhanced CT scan of the neck confirmed left-sided mixed laryngopyocele with contralateral mixed laryngocele. Patient underwent excision of both the lesions in a single stage by transcervical approach. Laryngopyocele in a case of bilateral mixed laryngocele presenting as an impending airway emergency has not been reported in literature. The diagnostic and therapeutic challenges are discussed here along with review of literature.
Asunto(s)
Obstrucción de las Vías Aéreas/diagnóstico , Trastornos de Deglución/diagnóstico , Laringocele/diagnóstico , Insuficiencia Respiratoria/diagnóstico , Adulto , Obstrucción de las Vías Aéreas/etiología , Trastornos de Deglución/etiología , Diagnóstico Diferencial , Humanos , Laringocele/complicaciones , Masculino , Insuficiencia Respiratoria/etiologíaRESUMEN
Thyroglossal duct cysts (TGDCs) are the most common congenital neck mass and often present in the paediatric population as a painless mass in the midline. A lateralised neck mass presenting for the first time in an adult may raise more concern for malignancy or a laryngocele. A 50-year-old man presented with an asymptomatic right level II neck mass adjacent to the thyroid cartilage. Preoperative CT revealed a cystic mass right of the midline with an intralaryngeal component. Intraoperatively, the lesion tracked towards the central hyoid bone; a Sistrunk procedure was performed. Postoperative pathology revealed a small foci of thyroid tissue within the mass. Careful consideration of the origin of this unusually presenting TGDC enabled appropriate operative management.
Asunto(s)
Laringocele/diagnóstico , Quiste Tirogloso/diagnóstico , Diagnóstico Diferencial , Humanos , Hueso Hioides/patología , Masculino , Persona de Mediana Edad , Cuello/patologíaRESUMEN
BACKGROUND: Transoral robotic surgery (TORS) has emerged as a novel, safe, and feasible procedure for the resection of malignant supraglottic laryngeal cancers. The purpose of this study was to demonstrate the surgical technique with extension of the use of TORS to excise a laryngeal cyst. RESULTS: Laryngeal cyst resection, along with its tract, was accomplished with preservation of both false and true vocal cords. There was no perioperative or early postoperative complications. The patient was extubated immediately after surgery. Oral diet was initiated within 24 hours. No tracheostomy was required. A video demonstration of the surgical technique is included on Head & Neck's website. CONCLUSION: TORS is a safe and feasible procedure for excision of selected laryngeal cysts.
Asunto(s)
Laringocele/diagnóstico , Laringocele/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Adulto , Humanos , Laringoscopía/métodos , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Monitoreo Intraoperatorio/métodos , Boca , Posicionamiento del Paciente , Seguridad del Paciente , Resultado del TratamientoRESUMEN
The incidence of laryngopyocoele is very unusual and only 41 cases have been documented in the world literature. Although hoarseness and stridor are the predominant symptoms associated with laryngocoele,patient can present with a recurrent neck abscess misleading to an infected branchial cyst. Complete excision of the cyst can be effectively achieved by the transcervical approach, especially in case of a large lateral cyst in a stable patient.
Asunto(s)
Laringocele/diagnóstico , Adulto , Quiste Broncogénico/diagnóstico , Diagnóstico Diferencial , Edema/etiología , Femenino , Ronquera/etiología , Humanos , Laringocele/complicaciones , Laringocele/diagnóstico por imagen , Laringocele/cirugía , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To describe risk factors, clinical presentation, and outcome of patients with saccular disorders. STUDY DESIGN: Case control with chart review METHODS: A single center retrospective study. Case group included all adult patients, presenting with saccular disorders (saccular cyst or laryngocele), between the years 2010 and 2015. A matched group of patients with vocal fold cyst served as the control. RESULTS: Twenty-nine patients met the inclusion criteria: 15 males and 14 females; the mean age was 60.5(±11.2). The median follow-up period was 10 months (range 2-48). Overall, 75.9% (22) had a positive smoking history; 55.2% (16) were active and 20.7% (6) were past smokers. The median pack- years of all smokers in the saccular disorder group was 40 (range 1-67). Saccular disorder patients demonstrated significantly higher prevalence of active smoking when compared to control patients (55.2% versus 17.9%, P = 0.014). Sixty-nine percent of the patients had some synchronous vocal fold comorbidity. The leading vocal fold comorbidity was Reinke's edema in 41% (12). Synchronous vocal fold comorbidities were significantly more prevalent in smokers compared with nonsmokers-82% (18 of 22) and 29% (2 of 7), respectively (P = 0.008). Surgical treatment was performed on 26 patients; all of whom underwent complete resection, either by endoscopic (92%), external (4%), or combined external and endoscopic (4%) approaches. There was a single case of recurrence (4%), 10 months following initial resection. CONCLUSION: Saccular disorders are associated with smoking and synchronous vocal fold comorbidity. Complete resection is recommended as surgical outcome is excellent.
Asunto(s)
Quistes/epidemiología , Enfermedades de la Laringe/epidemiología , Laringocele/epidemiología , Fumar/efectos adversos , Fumar/epidemiología , Trastornos de la Voz/epidemiología , Anciano , Comorbilidad , Quistes/diagnóstico , Quistes/fisiopatología , Quistes/cirugía , Femenino , Humanos , Israel/epidemiología , Enfermedades de la Laringe/diagnóstico , Enfermedades de la Laringe/fisiopatología , Enfermedades de la Laringe/cirugía , Laringectomía , Laringocele/diagnóstico , Laringocele/fisiopatología , Laringocele/cirugía , Laringoscopía , Masculino , Persona de Mediana Edad , Prevalencia , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Pliegues Vocales/fisiopatología , Pliegues Vocales/cirugía , Trastornos de la Voz/diagnóstico , Trastornos de la Voz/fisiopatología , Trastornos de la Voz/cirugía , Calidad de la VozRESUMEN
Laryngocele is an uncommon condition that represents a benign dilatation of the laryngeal saccule with air and/or fluid, arising in the region of the laryngeal ventricle. Laryngoceles, or laryngomucocele can be classified as internal, or combined. The aim of presenting this rare case of a bilateral combined laryngocele, are to emphasize the importance of diagnostic laryngoscopy in upper airway pathologies evaluation, increase awareness in the general otolaryngologist community, and to highlight the external surgical method.
Asunto(s)
Laringocele/diagnóstico , Humanos , Laringocele/diagnóstico por imagen , Laringocele/patología , Laringocele/cirugía , Laringoscopía , Laringe/patología , Laringe/cirugía , Masculino , Persona de Mediana Edad , Radiografía , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVES: Laryngoceles are air-filled sacs which communicate with the laryngeal lumen. When filled with mucus or pus, they are called laryngomucoceles and laryngopyoceles, respectively. Transoral robotic surgery (TORS) is a new and remarkable technique that expands its usefullness in otorhinolaryngology. Conventional treatments for laryngoceles were previously performed using external approaches, with aesthetically unfavorable and less function-sparing results. Transoral laser microsurgical approaches for laryngoceles were seldom reported. It is aimed to present authors' clinical experience on laryngocele management with TORS which is a rather new technique. STUDY DESIGN: A retrospective patient serial. METHODS: Patients were evaluated for demographic data, type of lesion, reasons for hospital admittance, complaint duration, and previous surgery. Robotic surgery panel including anesthesia time, duration of surgery, need for tracheotomy, postoperative care, follow-up, and recurrence rates were also summarized. RESULTS: Six men (mean age 51.7 years; range 41-62) with laryngoceles underwent successful TORS. Dyspnea and hoarseness were the main complaints. Two patients had undergone previous laryngeal surgery due to laryngeal cancer, with no recurrence of malignancy at admittance for laryngocele. Three had simple laryngocele, 2 had laryngomucocele, and 1 had laryngopyocele. No laryngoceles recurred and no complication such as dysphonia or prolonged dysphagia occurred. CONCLUSION: Transoral robotic surgery was found superior in safety, technical feasibility and curative effectiveness, when compared with classical methods, especially due to absence of skin incisions. Surgical modalities for laryngocele excision should be directed toward a curative target including cosmetic and functional success, technical achievability, and surgically curative methods. Transoral robotic surgery provided all these features.
Asunto(s)
Laringocele/cirugía , Laringe/cirugía , Cirugía Endoscópica por Orificios Naturales/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Adulto , Humanos , Laringocele/diagnóstico , Laringe/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Boca , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
Las alteraciones congénitas del cuello constituyen un desafío para los médicos de familia y los especialistas. Aunque algunas de ellas son diagnosticadas de forma intrauterina, la mayoría permanecen silentes y se manifiestan en el contexto de infecciones a lo largo de la vida. La localización anatómica, la consistencia y la edad son determinantes en la orientación del posible diagnóstico. Una masa cervical en línea media infrahioidea hará pensar en un quiste tirogloso. Si es lateral, descartaremos un quiste braquial. Los estudios complementarios por imagen son fundamentales, sin olvidar pruebas anatomopatológicas como punción aspiración de aguja fina (PAAF) (AU)
Congenital neck masses are a challenge for general practitioners and specialists. Although some of them are diagnosed in utero, most of them remain silent until complications appear in the adult age. The anatomical location, consistency and age are determinants in guiding the possible diagnosis. A midline infrahyoid mass may be a thyroglossal cyst, however a lateral neck mass is more possible to result in a brachial cyst. Complementary imaging studies are essential such as pathological tests like needle aspiration fine needle aspiration (FNA) (AU)
Asunto(s)
Humanos , Masculino , Femenino , Cuello/anomalías , Diagnóstico Diferencial , Región Branquial/anomalías , Región Branquial/patología , Quiste Tirogloso/diagnóstico , Quiste Tirogloso/terapia , Malformaciones Vasculares/diagnóstico , Malformaciones Vasculares/terapia , Malformaciones Vasculares , Medicina Familiar y Comunitaria/métodos , Vértebras Cervicales/anomalías , Vértebras Cervicales/patología , Tomografía Computarizada de Emisión , Quiste Tirogloso , Tortícolis/terapia , Teratoma/diagnóstico , Teratoma/terapia , Timo/anomalías , Laringocele/diagnósticoRESUMEN
A 68-year-old man was referred to the Department of Otolaryngology because of a swelling of his neck and hoarseness. CT imaging of his neck revealed a cystic mass in the larynx as well as in the neck, with an air-fluid level. The diagnosis 'laryngopyocele' was made.
Asunto(s)
Laringocele/diagnóstico , Anciano , Edema/diagnóstico , Edema/etiología , Ronquera/diagnóstico , Ronquera/etiología , Humanos , Masculino , Cuello/patología , Fumar/efectos adversosRESUMEN
BACKGROUND: Air travel mostly causes minor ear, nose and throat complaints. We describe a second report in literature of airway obstruction caused by a drop in atmospheric pressure during a routine commercial flight. CASE PRESENTATION: A 54-year-old male was referred to a head and neck surgeon with a 2 cm left submandibular mass that would enlarge during commercial flights. As the plane gained elevation, the mass would grow and cause him to become stridorous and short of breath. The shortness of breath and stridor would only resolve upon landing of the plane. A CT scan showed a large air sac extending from the larynx at the level of the true vocal cords up to the angle of the mandible. Based on the history and the CT findings a diagnosis of a laryngocele was made. The laryngocele was excised using an external approach, resolving the patient's difficulty with flying. CONCLUSION: This article reports a rare case of upper airway obstruction caused by atmospheric pressure changes during air travel. The reported case is of significance as only a few uncomplicated laryngoceles have been reported to cause airway distress in the literature. This report highlights the epidemiology, presentation, complication and management of laryngoceles.
Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Mal de Altura/complicaciones , Altitud , Laringocele/complicaciones , Laringoscopía/métodos , Tomografía Computarizada por Rayos X/métodos , Obstrucción de las Vías Aéreas/diagnóstico por imagen , Humanos , Laringocele/diagnóstico , Laringocele/cirugía , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To describe an experience with laryngeal oncocytic cystadenomas and review the published literature regarding this uncommon diagnosis. METHODS AND RESULTS: A clinical review of patients presenting with cystic laryngeal masses in an urban academic medical center between January and December 2013 was performed. Three patients, two female and one male, with a mean age of 68 years, were diagnosed with oncocytic cystadenomata of the larynx. Major presenting symptoms included dysphonia, globus, and ipsilateral otalgia. Endoscopic examinations revealed a cystic structure arising from varied subsites of the larynx: laryngeal ventricle, aryepiglottic fold, and pre-epiglottic space. Cross-sectional radiographic imaging was obtained in each case. The patients were treated with transoral (CO2) laser microsurgery (TLM). In all three cases, pathological analysis revealed oncocytic cystadenoma with clear margins. CONCLUSIONS: Oncocytic cystadenoma is a rare entity of the larynx predominantly affecting elderly patients. Clinical presentation and imaging may suggest the diagnosis of an internal laryngocele. Complete excision is both diagnostic and therapeutic, and typically can be achieved using TLM. When clear margins are obtained, no adjuvant therapy is indicated. Although laryngoceles and malignancies are more commonly encountered, oncocytic cystadenomas should remain in the differential of cystic laryngeal masses.