Overview
Acquired laryngocele is an abnormal dilation of the laryngeal ventricle, typically resulting from increased intraluminal pressure, often secondary to vocal fold immobility or paralysis. It can manifest as internal or external types, with internal laryngoceles potentially causing severe respiratory distress if they obstruct the airway 2.Diagnosis
Clinical Presentation: Recurrent episodes of dyspnea, particularly in elderly patients 2.
Endoscopic Examination: Flexible nasopharyngolaryngoscopy to visualize the dilated laryngeal ventricle 2.
Imaging: CT or MRI may be used to assess the extent and complications of the laryngocele 2.Management
Surgical Intervention: Laryngomicrosurgery for definitive removal, especially in cases of airway obstruction 2.
Emergency Measures: Tracheotomy may be necessary in severe cases to secure the airway 2.
Conservative Management: Limited evidence; primarily supportive care until definitive surgery can be performed 2.Special Populations
Elderly Patients: Higher vigilance required due to increased risk of airway obstruction and severe symptoms 2.Key Recommendations
Consider internal laryngocele in the differential diagnosis of unexplained dyspnea, particularly in elderly patients (Evidence: Moderate 2).
Perform flexible nasopharyngolaryngoscopy for diagnosis and assess airway patency in suspected cases (Evidence: Moderate 2).
Emergency tracheotomy should be considered when laryngocele causes significant airway obstruction (Evidence: Expert opinion 2).References
1 Kostas JC, Lee AS, Arunkumar A, Han C, Lee M, Goel AN et al.. Validation of a 3D-Printed Percutaneous Injection Laryngoplasty Simulator: A Randomized Controlled Trial. The Laryngoscope 2024. link
2 Spinosi MC, Mezzedimi C, Monciatti G, Passali D. Internal Laryngocele: Unusual onset in a 91-year-old female patient. Sultan Qaboos University medical journal 2018. link