Management of Laryngoceles in Upper Airway Disorders

Laryngoceles are air‐filled dilatations of the laryngeal saccule that may present as internal, external or combined types, and although often incidental, they can produce significant symptoms such as hoarseness, neck swelling, dyspnoea, stridor or cough. Management is guided by lesion type, symptom severity and risk of airway compromise. Endoscopic techniques, notably microlaryngoscopic resection with a CO₂ laser and, in select centres, transoral robotic surgery, have become first‐line for internal laryngoceles, offering precision and reduced morbidity. Combined or large external components continue to require open cervical approaches to achieve complete excision and minimise recurrence. Infected laryngoceles (laryngopyoceles) or lesions that expand dynamically—such as with changes in atmospheric pressure—may precipitate acute airway obstruction, mandating emergency tracheostomy or endoscopic drainage before definitive surgery. A multidisciplinary team approach, incorporating detailed imaging, airway safety protocols and tailored surgical planning, underpins current best practice and supports favourable outcomes across diverse clinical settings.

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Management of Laryngoceles in Upper Airway Disorders publication trend

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Technical terms

Laryngocele: An air‐filled herniation of the laryngeal saccule that communicates with the laryngeal lumen.

Internal laryngocele: A laryngocele confined within the paraglottic space without external neck extension.

Laryngopyocele: An infected laryngocele containing purulent material, often presenting with pain, fever and airway compromise.

Microlaryngoscopy: An endoscopic surgical technique using a suspension laryngoscope for direct access to the larynx, frequently combined with laser resection.

External approach: An open surgical technique via a cervical incision to excise laryngoceles with external or combined components.

References

1. Treatment of Laryngoceles: What Is the Progress over the Last Two Decades?. BioMed Research International (2014).
2. Endoscopic Management of an Internal Laryngopyocele Presenting with Acute Airway Obstruction. Case Reports in Surgery (2011).
3. Upper airway obstruction due to a change in altitude: first report in fifty years. Journal of Otolaryngology (2016).
4. Internal Laryngocele: Unusual onset in a 91-year-old female patient. Sultan Qaboos University Medical Journal (2018).