Laryngocoele presenting as acute airway obstruction

A laryngocoele is an abnormal dilatation of the laryngeal saccule. Symptomatic laryngocoeles can present as rapidly developing airway obstruction. In this case report of a 37-year-old man with a laryngocoele, we discuss the management dilemma presented by his repeated flight from the hospital prior to definitive treatment. This resulted in repeated admissions with life-threatening airway symptoms, culminating in emergency tracheostomies. Surgical excision of the laryngocoele was not achieved until the third presentation. We recommend early surgical intervention in patients who are potentially non-compliant to treatment or follow-up. A brief literature review of laryngocoele, as well as management of the difficult airway, are also discussed.