Endoscopic CO2 laser management of laryngocele.
OBJECTIVE
To report on the management of laryngoceles by CO2 laser-assisted endoscopic excision.


METHODS
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 CO2 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.


CONCLUSIONS
CO2 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.
Martinez Devesa
Pablo
P
Professorial Unit of the Royal National Throat, Nose and Ear Hospital, London, United Kingdom. pablo@2oto.fsnet.co.uk
Ghufoor
Khalid
K
Lloyd
Simon
S
Howard
David
D
D000328:Adult; D000368:Aged; D002245:Carbon Dioxide; D004108:Dilatation, Pathologic / Q000601:surgery; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D007828:Laryngoscopy; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D002245:Carbon Dioxide