Terminology, Definitions, and Classification in the Imaging of Laryngoceles

We aim to better define the anatomy, criteria, and classification of laryngoceles, and to raise the awareness to potential mimickers and anatomical variants leading to misdiagnosis.

A retrospective review of all computed tomography studies, performed over a decade, with the diagnosis of "laryngocele" in the radiological report in a tertiary medical center. All relevant studies were reviewed by two independent readers for the presence of true laryngoceles.

One hundred and twelve patients were included; average age was 54 (±18). Re-read of scans with 3D reconstructions resulted in detecting 58 (52%) true laryngoceles, with 19.5% bilateral laryngoceles. Anatomical variants and laryngocele mimickers formerly misdiagnosed as laryngoceles included 26/54 (48%) prominent ventricles, 19/54 (35%) saccules not meeting criteria for laryngocele, 8/54 (15%) prominent pyriform sinuses and one tracheal diverticulum.

Intimate knowledge of the laryngeal anatomy, the criteria for a laryngocele and anatomical variants as well mimickers, is the key to avoid radiological misdiagnosis.