Open Access Highly Accessed Case report

Laryngocele: a rare complication of surgical tracheostomy

Tahwinder Upile12*, Waseem Jerjes1, Fabian Sipaul2, Mohammed El Maaytah1, Sandeep Singh2, David Howard2, Colin Hopper1 and Anthony Wright12

Author Affiliations

1 Oral & Maxillofacial Surgery/Head & Neck Unit, University College London Hospitals, London, UK

2 The Royal National Throat, Nose and Ear Hospital, London, UK

For all author emails, please log on.

BMC Surgery 2006, 6:14  doi:10.1186/1471-2482-6-14

Published: 27 November 2006

Abstract

Background

A laryngocele is usually a cystic dilatation of the laryngeal saccule. The etiology behind its occurrence is still unclear, but congenital and acquired factors have been implicated in its development.

Case presentation

We present a rare case of laryngocele occurring in a 77-year-old Caucasian woman. The patient presented with one month history of altered voice, no other associated symptoms were reported. The medical history of the patient included respiratory failure secondary to childhood polio at the age of ten; the airway management included a surgical tracheostomy.

Flexible naso-laryngoscopy revealed a soft mass arising from the posterior pharyngeal wall obscuring the view of the posterior commissure and vocal folds. The shape of the mass altered with respiration and on performing valsalva maneuver. A plain lateral neck radiograph revealed a large air filled sac originating from the laryngeal cartilages and extending along the posterior pharyngeal wall. The patient was then treated by endoscopic laser marsupialization and reviewed annually.

We discuss the complications of tracheostomy and the pathophysiology of laryngoceles and in particular the likely aetiological factors in this case.

Conclusion

A laryngocele presenting in a female patient with tracheostomy is extremely rare and has not been to date reported in the world literature. A local mechanical condition may be the determinant factor in the pathogenesis of the disease.