[Laryngocele. Possibilities and limitations of surgical treatment under direct microlaryngoscopy]

Three cases of laryngocele are reported, which were managed by surgery under direct microlaryngoscopy with excellent clinical and functional results, both at short and long term. According to the classification of Y. Lacomme, two patients had an internal or vestibular laryngocele, which was of the low type in one of them and of the middle type in the other. In the first case the pouch and the false vocal fold lying over it were completely removed under direct microlaryngoscopy. In the second case the laringeal cavity was marsupialized after extensive resection of the false fold and part of the lateral wall of the vestibule. Over a short period of time both patients were symptom-free and eventually recovered completely. In the third case tha laryngocele was of a classic mixed type. The patient, who risked suffocation, was elderly (77 years of age) and extremely debilitated. A few days earlier he had had an emergency tracheotomy for severe respiratory failure. Surgery under direct microlaryngoscopy consisted in removing the false fold and the internal laryngocele. About one and ahalf months later, the tracheostomy opening had closed and the latero-cervical pouch had been gradually reduced. The latter was drained abundantly into the laryngeal lumen and remained as an external laryngocele. When the patient is in good enough condition, the laryngocele will be completely removed by means of the most suitable among the common external-approach surgical techniques.