Observations on the size of the saccule in laryngectomy specimens

Over 300 instances of the association of laryngocele with laryngeal carcinoma have been reported in Europe, but only seven in North America. In the present study, 353 serially sectioned total laryngectomy specimens were examined and the saccule measured with a steel ruler. Saccules extending superior or posterior to the thyroid cartilage were considered as large. Larynges were classified as "cancer" or "normal", the latter being uninvaded organs from patients with adjacent disease. Among the 242 cancer larynges, there were 43 specimens where the saccule exceeded thyroid cartilage dimensions, a laryngocele rate of 17.8%. Mean saccule height was significantly greater in cancer than in normal specimens in coronal sections (P = 0.04), and mean saccule length was significantly greater in cancer than in normal specimens in horizontal sections (P = 0.001). The incidence of large saccules showed a difference between cancer and normal larynges which was highly significant (P = 0.0002).