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Endoscopic CO 2 Laser Management of Laryngocele
Author(s) -
Devesa Pablo Martinez,
Ghufoor Khalid,
Lloyd Simon,
Howard David
Publication year - 2002
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200208000-00018
Subject(s) - medicine , tracheotomy , surgery , cyst , larynx , airway obstruction , airway , radiology
Objective To report on the management of laryngoceles by CO 2 laser‐assisted endoscopic excision. Study Design A 15‐year retrospective study of 12 adult patients (7 men and 5 women) who presented with a laryngocele. Nine patients had an internal laryngocele, one patient had an external laryngocele, and two patients had combined internal‐external components. Two laryngoceles were right‐sided, six were left‐sided, and four were bilateral. Methods An endoscopic examination of the laryngocele was carried out for both diagnostic and therapeutic purposes. Once identified the air‐ or mucus‐filled cyst (extending from the laryngeal ventricle into the paraglottic space and beyond the thyrohyoid membrane in some cases), the laryngocele was excised in toto, with its surrounding capsule, via endoscopic approach using the CO 2 laser. Results The main presenting symptom was dysphonia in seven patients, visible or palpable mass in the neck in three, and upper airway obstruction in the remaining two. All laryngoceles were treated with endoscopic laser excision of the internal and external components when required. The average postoperative stay in hospital was 1.8 days. Only two of the patients treated had a tracheotomy; both cases presented elsewhere with an emergency airway obstruction, which necessitated tracheotomy. In these two cases, decannulation was subsequently performed. There were no significant complications. The follow‐up ranged from 6 months to 5 years. Conclusion CO 2 laser‐assisted endoscopic excision of a laryngocele is a quick, precise, and safe alternative to an external approach excision (lateral thyroidotomy, laryngofissure) with fewer complications than its external counterparts, resulting in speedier rehabilitation of both the patient and his or her voice.