Case report: Sudden stridor and cervical swelling due to a rapidly increasing acquired laryngocele

Introduction A laryngocele is a lateral dilatation of the laryngeal ventricle of Morgagni. It can be congenital or acquired and presents clinically as a swelling of the neck.

Case Report: A 58-year-old female patient presented with a persistent, painless, non-fluctuating swelling of the left side of the neck lasting for 2 months. She was additionally suffering of hoarseness and exertional dyspnea for 10 days. There was no dysphagia, odynophagia or B symptoms present, instead developing a sudden and gradually progressive stridor.

Upon examination there was an endolaryngeal, nonirritating flat and edematous swelling of the left vallecula towards the left aryepiglottic fold. Symmetrical mobility and opening of the vocal chords was present. A nonirritating, painless and soft swelling was found on the left side of the neck (Level II), measuring 4 cm.

The CT scan of the neck showed an 42x 37x 29 mm air-filled swelling in the left cervical area just below the epiglottis without communication to the trachea. This lead to a compression and lateralisation of the larynx and the upper trachea.

We removed the laryngocele via lateral pharyngotomy with wide opening the left ventricle of Morgagni under general anaesthesia. The Laryngocele was removed completely and the entrance was closed using a three layer method.

Conclusion An acquired laryngocele can rapidly increase in size and cause stridor and hoarseness. It should be considered as a differential diagnosis of a nonirritating laryngeal swelling. The diagnosis can be confirmed by CT scan. Therapy of choice is the complete surgical excision.

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Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021