A laryngocoele is an abnormal dilatation of Morgagni's ventricle in direct communication with the laryngeal lumen. Surgical excision through a cervical approach is traditionally considered the treatment of choice for large (external and mixed) laryngocoeles. This paper describes the first reported case of a large mixed laryngocoele treated with transoral robotic surgery without cervical incisions.

A 69-year-old female underwent transoral robotic surgery for the excision of a large mixed left laryngocoele. The surgery was performed using the da Vinci S surgical robotic system (Intuitive Surgical, Sunnyvale, California, USA).

No complications were observed and the patient was discharged 2 days post-operation.

Transoral robotic surgery enabled accurate dissection with complete removal of the large mixed laryngocoele via a minimally invasive approach. The advantages of transoral robotic surgery over other techniques for laryngocoele excision are discussed.

This study sought to evaluate the incidence, aetiology, clinical features and treatment modalities for laryngocoele formation after supracricoid partial laryngectomy.

The medical charts of 62 patients who had undergone supracricoid partial laryngectomy were reviewed.

Three patients developed laryngocoele, giving an incidence of 4.8 per cent. Two of these patients presented with a cervical mass, dyspnoea and fever. The mobility of the arytenoids was disturbed on the involved side. The third patient was admitted complaining only of a compressible cervical mass. In all patients, diagnosis was made by computed tomography scan. The transcervical surgical approach was preferred for resection.

Laryngocoele can occur as a late complication of supracricoid partial laryngectomy. Remnants of the laryngeal ventricle may be the cause of laryngocoele formation. The integrity of the laryngeal ventricle in the resected specimen should be routinely checked in order to avoid this rare complication. Clinicians should be aware that, following supracricoid partial laryngectomy, a cervical mass presenting with dyspnoea and disturbance of arytenoid mobility does not always indicate tumour recurrence.

We report a case of unilateral combined laryngocoele occurring in conjunction with recurrent respiratory papillomatosis.

Case report and review of the literature concerning the physiology underlying laryngocoele formation.

A laryngocoele is an abnormal, air-filled dilation of the laryngeal saccule which communicates with the laryngeal lumen. We report a case of a 53-year-old man with a unilateral combined laryngocoele occurring in conjunction with recurrent respiratory papillomatosis. Microlaryngoscopy demonstrated a papilloma obstructing the laryngeal saccule. Removal of papillomata via laser excision and marsupialisation of the left laryngocoele improved the patient's vocal symptoms. There was no recurrence of papillomata or the laryngocoele.

While many laryngocoeles can be explained by altered laryngeal physiology, the papilloma described in this case acted as an anatomical obstruction that trapped air within the saccule, creating an environment conducive to laryngocoele formation.

We present the first reported case of ultrasound-guided aspiration of a laryngopyocoele in a patient with acute airway obstruction.

A 71-year-old woman was diagnosed with a right-sided laryngocoele. Six weeks later, the patient was admitted as an emergency with a three-day history of increasing dyspnoea and stridor. Neck examination revealed a large, right-sided, soft neck mass, centred at level III, measuring approximately 10 × 5 cm. Fibre-optic laryngoscopy revealed a large, smooth, inflamed, right supraglottic mass obscuring the laryngeal inlet. The patient was taken directly to the radiology department, where ultrasound imaging confirmed a laryngopyocoele. Under ultrasound guidance, a 21-G needle was directed into the cyst and 30 ml of pus was aspirated. The dysphonia and stridor resolved immediately. Six weeks later, the patient underwent definitive surgical excision of the laryngocoele.

Laryngopyocoele is a rare diagnosis. It can present as an acute airway emergency. We present the first reported case managed by ultrasound-guided aspiration, which averted the need for endotracheal intubation or tracheostomy.

We report a unique case of a squamous cell carcinoma of the larynx presenting as a large pseudolaryngocoele, arising through a thyroid cartilage defect.

Case report and review of the literature.

A 47-year-old man presented with a two-month history of hoarseness and a large, midline neck swelling. Endoscopic examination revealed a transglottic carcinoma involving the anterior commissure. Fine needle aspiration of the neck mass showed it to be an air-filled structure which transiently collapsed but refilled within minutes. Subsequent computed tomography scanning and histopathological examination revealed that the air-filled mass was created by a defect in the thyroid cartilage, with formation of a pseudolaryngocoele.

The anatomy of the anterior commissure region and its effect on the spread of laryngeal carcinoma is reviewed in order to explain the pathophysiology of this unusual presentation. We highlight the need for a high index of suspicion of malignancy if a laryngocoele or pseudolaryngocoele is detected clinically.