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Detailed information of LARYNGOCELE
LARYNGOCELE
DEFINITION:
A congenital disorder of the larynx characterized by varying
degrees of upper airway obstruction and a neck mass.
EPIDEMIOLOGY:
- incidence: rare (about 200 cases reported)
- age of onset:
- 40% detected at birth and 95% by 6 months of age
- risk factors:
PATHOGENESIS:
- in persons with congenitally large ventricular appendices,
increased intraluminal laryngeal pressure (with straining,
crying, singing, etc.) may cause the laryngeal appendix to
dilate and form a saccular cyst which can remain either internal
to the larynx or expand externally
2. Classification
- internal, external, or both
- the internal cystic mass may expand through a perforation
site in the thyrohyoid membrane at the neurovascular bundle to
form an external cystic mass
2. Content
- aerocele, pyocele, mucocele
- the cysts are lined with ciliated respiratory epithelium
and contain mucous-secreting glands
CLINICAL FEATURES:
- 90% - stridor
- 55% - dyspnea
- 50% - feeding problems
- 20% - chronic cough
2. External Laryngocele
- presents as a cyst-like neck mass between the hyoid bone and
the thyroid cartilage over the thyrohyoid membrane - tends to
enlarge with straining and decrease in size at rest
- may collapse with gentle pressure
- compression of the mass may produce gurgling or hissing in
the throat (Bryce sign)
3. Complications
- hoarseness, dysphagia
- respiratory manifestations
- aspiration +/- pneumonia
- upper airway obstruction
- laryngeal carcinoma
- may develop in up to 50% of patients with laryngocele
INVESTIGATIONS:
MANAGEMENT:
- respiratory support with severe or life-threatening upper
airway obstruction, i.e., intubation, tracheostomy
2. Surgery
- cyst decompression by needle aspiration or surgical
unroofing
- excision - surgical, laser
3. Prognosis
- normal life span and intelligence
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Pediatric Database - LARYNGOCELE
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