Name : Hamid
Email : ----------------
Resident : Samira Shahhamzei
Gender : Male
Age : 56
Head & Neck Imaging
56 Y/O man with hoarseness and old neck trauma who referred for neck CT scan
Imaging Procedures and Findings
Axial CT images (figure 1,2) show the air filled structure in the right paraglottic space above the true cord level. The mucosa is intact and this structure doesn??t protrude through the thyrohyoid membrane . Figure 3 is another patient with hx of playing saxophone complying from neck mass. Note the more lateral position of the lesions , beyond the thyrohyoid membrane.
Laryngocele is a sub mucosal saccular cystic mass , represents as a dilatation of the ventricular saccule or appendix. Strict terminology refers to the abnormality as a saccular cyst if fluid filled and as a laryngocele if air filled. The laryngocele is a supraglottic abnormality, and the true cord is normal. It presents as a submucosal mass or bulge in the supraglottic larynx. A small cyst or laryngocele may be confined to the supraglottic paraglottic space and is referred to as internal. A larger lesion may protrude laterally through the thyrohyoid membrane just anterior to the upper horn of the thyroid cartilage. Any component outside the membrane is referred to as external. A pure external laryngocele is rare. Occasionally a small air-filled external laryngocele is identified with no obvious dilata- tion of the part of the saccule within the paraglottic space. This is usually an incidental finding. The external compo- nent is more commonly seen in combination with an internal component. This is called a mixed laryngocele. When the external component is large, the laryngocele can present as a neck mass. Laryngoceles and saccular cysts are benign. However, these abnormalities can occur when tumor in the ventricle causes obstruction of the laryngeal saccule; therefore, both the radiologist and the endoscopist must carefully examine this key area .
Haaga John R. CT AND MRI OF The Whole Body,5th edition. P684-686