Endoscopic management of a combined laryngocele

A 70-year-old women presented with hoarseness, foul sputum, and a softneck mass. Clinical and radiographic examination disclosed findings consistent with a combined internal and external laryngopyocele. Antibiotics, throat irrigations, and warm packs applied to the neck resulted in full resolution of the neck mass and subtotal regression of the supraglottic swelling. Endoscopic vestibulectomy was performed with a carbon dioxide laser; neither residual neck mass nor a tract leading to the extralaryngeal neck swelling was detected. The immediate and long-term clinical course has been uneventful. This report is the first description of the definitive endoscopic management of a combined laryngocele. The pathogenesis of the laryngocele and the rationale and technique for endoscopic management are discussed.