Laryngopyocele: A Rare Cause of Upper Airway Compromise

Laryngocele is defined as the abnormal dilatation of the laryngeal saccule by air, and when it becomes infected, it is termed a laryngopyocele. Laryngopyoceles can present acutely with airway compromise and swallowing difficulties, along with other symptoms such as hoarseness and neck pain. A 78-year-old male with a history of chronic obstructive pulmonary disease presented with a progressively enlarging left-sided neck swelling over 30 years, recently associated with hoarseness, dysphagia, and respiratory distress. Examination and imaging confirmed a mixed laryngopyocele causing significant airway compromise. An emergency tracheostomy was performed, followed by definitive excision via an external cervical approach. Intraoperatively, 12 mL of pus was drained, and histopathology revealed an inflamed cyst lined by respiratory epithelium. The patient recovered well, with successful decannulation and complete resolution of symptoms. Mixed laryngopyoceles are uncommon but may present as airway emergencies, and early recognition, prompt airway management, and complete surgical excision are essential for optimal outcomes.