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Mixed (external) laryngocele.

Laryngoceles occur when the laryngeal ventricle or its more distal saccule (appendix) becomes functionally obstructed as a result of an increase in intraglottic pressure, such as that caused by excessive coughing, playing a wind instrument, glass blowing, etc. A less common cause is an obstruction of the proximal saccule by a postinflammatory stenosis, trauma, or tumor (e.g., squamous cell carcinoma). The laryngocele can be filled with air, fluid, or purulent material. As the laryngocele enlarges, it penetrates the thyrohyoid membrane and enters the submandibular space. (1)

On computed tomography (CT), a mixed (external) laryngocele appears as a well-marginated, air- or fluid-filled cystic mass in the lower submandibular space at the level of the thyrohyoid membrane. The isthmus (or waist) through the perforation of the membrane is readily identified (figure). The internal component of the mixed laryngocele can be collapsed and not well visualized. In addition, CT might readily demonstrate an internal (or simple) laryngocele, a pyolaryngocele, or a secondary laryngocele; the latter can be formed when a small tumor obstructs the opening of the ventricle in the supraglottis.

In a LETTER TO THE EDITOR in the March issue of EAR, NOSE, AND THROAT JOURNAL, a comment was made regarding the differentiation between laryngoceles and pharyngoceles. (2) The latter term refers to the air-filled neck masses that arise in the pharynx in the region of the pyriform sinuses.

References

(1.) Harnsberger HR. Cystic masses of the head and neck: Rare lesions with characteristic radiologic features. In: Harnsberger HR. Handbook of Head and Neck Imaging. 2nd ed. St. Louis: Mosby, 1995:199-223.

(2.) Ward PH. Bilateral laryngoceles in a young trumpet player: Case report [letter]. Ear Nose Throat J 2001;80:132.

From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans (Dr. Palacios), and the Department of Radiology and Otolaryngology, University of Illinois Medical Center, Chicago (Dr. Valvassori).
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Article Details
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Title Annotation:Imaging Clinic
Author:Valvassori, Galdino E.
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 2001
Words:311
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