Endoscopic CO₂ Laser Resection Using the Inversion Technique in 22 Combined Laryngoceles

To demonstrate the feasibility of transoral resection of, even large, combined laryngoceles by endoscopic CO₂ laser resection using the inversion technique.

A retrospective study over a 25-year period of 20 patients with 22 combined laryngoceles. All patients were operated on using the CO₂ laser inversion technique. Pre- and postoperative computed tomography (CT)-scans or magnetic resonance (MR) imaging were available in all patients.

There were no surgical problems during all procedures. One patient required a tracheotomy pre-operatively due to a compromised airway. All procedures were without intraoperative complications. Postoperatively, there were two complications: one hemorrhage, and one patient developed a granuloma with airway compromise. In two patients, residual disease was detected on postoperative imaging. One of them was re-operated several years later due to the progression of this residual external component of the laryngocele. One patient had a non-significant small internal laryngocele recurrence. The recurrence rate in this series was 2/22 (9.1%). The majority of patients (15/20) could be discharged from the hospital the day after surgery.

The results of this study show excellent control of combined laryngoceles using the CO₂ laser inversion technique, with a short hospital stay and a low rate of complications and recurrence. Even in large combined laryngoceles, CO₂ laser excision using the inversion technique should be considered.

4 Laryngoscope, 133:2742-2746, 2023.