Laryngeal Cysts

Epidemiology

Laryngeal cysts (LCs) is a term used to identify a variety of air-containing or fluid-filled cysts that include laryngoceles and saccular cysts. Laryngoceles and saccular cysts both result from dilatation of the laryngeal saccule. Laryngoceles have a persistent communication with the laryngeal ventricle, whereas a saccular cyst is isolated from the ventricle. Laryngoceles and saccular cysts may be seen in all ages. LCs may be seen in infants and children and are a known cause of stridor in newborn and young children. There is no reported gender predilection for LCs.

Laryngocele

A laryngocele is an abnormal dilatation or diverticulum of the ventricle that communicates with the laryngeal ventricle. These lesions may be filled with air or mucus, and have been classified as internal, external, or mixed. A laryngocele is termed an internal laryngocele when the mass is confined to the interior of the larynx and limited to the endolaryngeal structures of the larynx. An external laryngocele extends laterally through the thyrohyoid membrane into the soft tissues of the neck. This extension usually occurs through the natural opening in the membrane for the superior laryngeal artery. A laryngocele with both internal and external components is termed a mixed laryngocele.

Laryngoceles may be unilateral or bilateral. These lesions may become infected during periods of upper respiratory tract infections. Laryngoceles may be congenital or acquired. In children, these masses are felt to be congenital in origin. In adults, there is an increased association of laryngoceles with glottic tumors. Two to six percent of glottic squamous cell carcinomas are associated with laryngocele formation; therefore, malignancy must be excluded in any adult who presents with a laryngocele.