Article thumbnail

Internal laryngopyocele as a cause of acute airway obstruction: an extremely rare case and review of the literature

By I. VASILEIADIS, S. KAPETANAKIS, A. PETOUSIS, A. STAVRIANAKI, A. FISKA and E. KARAKOSTAS

Abstract

The laryngocele is an abnormal cystic dilatation of the saccule or appendix of the laryngeal ventricle, filled with air and communicating with the lumen of the larynx. When the neck of the laryngocele is obstructed, it becomes filled with mucus of the glandular secretion and is changed to a laryngomucocele. When this lesion becomes infected, a laryngopyocele is formed. The laryngocele is fairly rare and laryngopyocele occurs even more rarely. Overall, 39 cases of laryngopyocele have been reported in the world literature. Only in 4 cases was a laryngopyocele reported to have caused acute airway obstruction and only one case of internal laryngopyocele causing acute airway obstruction has been reported until now. This is the first case reported in the literature of an internal laryngopyocele in a female patient in a septic condition, which caused almost 100% obstruction of the airway. An emergency tracheotomy was performed in order to secure the airway. Computed tomography of neck was performed which revealed a cystic 29 mm hypodense mass extending from the right false vocal cord to the level of the epiglottis, narrowing the laryngeal cavity and causing an almost 100% airway obstruction. Laryngopyoceles may present with a rapid and alarming obstruction of the airway and, therefore, an urgent tracheotomy may be inevitable. It is an emergency case, in the field of otolaryngology, and should be included in the differential diagnosis of acute airway obstruction, especially when hoarseness, stridor and fever are present. Diagnosis requires a high index of suspicion for these lesions and scrupulous clinical and radiological evaluation. A computed tomography scan is critical in determining the nature and site of the lesion. The recommended treatment of laryngopyocele is immediate endoscopic drainage. Definitive management of laryngopyoceles is surgical excision which can be performed immediately after endoscopic drainage or some time thereafter

Topics: Case Report
Publisher: Pacini Editore SpA
OAI identifier: oai:pubmedcentral.nih.gov:3324965
Provided by: PubMed Central

Suggested articles

Citations

  1. (1966). Asympromatic laryngoceles in wind instrument bandsmen. arch Otolaryngol
  2. Bone rC.
  3. De la Cortina raC. Lateral thyrotomy approach on the paraglottic space for laryngocele resection.
  4. (2010). Delacure mD. The external approach for submucosal lesions of the larynx. Otolaryngol head neck Surg 2001;125:370-3. received: august 26,
  5. Fernandes Cm, pinto ap. Laryngopyocele (a report of two cases).
  6. Internal laryngopyocele presenting as acute airway obstruction.
  7. (1997). Kashima hK. Endoscopic management of combined laryngocele. ann Otol Laryngol
  8. laryngeal mucocele and large saccular cysts: a developmental spectrum. Laryngoscope
  9. Laryngocele – A study of five cases with reference to the radiologic features. Clin radiol 1987;38:639-
  10. (1978). Laryngocele and saccular cysts. ann Otol rhinol Laryngol
  11. Laryngocele: a rare complication of surgical tracheostomy.
  12. Laryngocele: case report and review of the literature.
  13. Laryngopyocele as a cause of airway obstruction.
  14. (2000). Lombardo p, marchese-ragona r, et al. Laryngopyocele: three new clinical cases and review of the literature. eur arch Otorhinolaryngol
  15. maran ag. The aetiology of laryngocoele.
  16. nehen am. Laryngopyocele with a report of two cases.
  17. Ozates m, uyar a, et al. Laryngopyocele: signs on computed tomography.
  18. (1996). paduano F, magliulo g. Laryngopyocele: an atypical case.
  19. Rare case of relapsing cervical infections.
  20. (1995). The anatomy and physiology of the mammalian larynx. Cambridge: Cambridge university press:

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.