Laryngocele
ICD-10 Q31.3 · ICD-11 LA71.1

Treatment of Laryngocele in Combined Laryngocele

Combined laryngocele presents a distinct anatomical challenge: the lesion occupies both the medial and lateral compartments relative to the thyrohyoid membrane, requiring careful consideration of which surgical strategy best addresses both components.

Clinical scenario

Internal laryngoceles expand medially to the thyroid hyoid membrane, while combined laryngoceles are positioned both medial and lateral to the membrane.

Laryngoceles that were considered external were included in the combined group, given that all laryngoceles originate from the internal structure of the saccule.

Approach

Management of combined laryngocele is surgical. Approaches range from procedures that combine internal endoscopic laser resection with an open technique, to strategies that address both components entirely via an endoscopic route, to a robotic-assisted method in selected cases. The specific choice depends on the anatomy and extent of the lesion—the full decision framework is in the structured protocol.

Treatment goal: no recurrence of the combined laryngocele up to 3 years after treatment.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1177/0300060520940441

Internal laryngoceles expand medially to the thyroid hyoid membrane, while combined laryngoceles are positioned both medial and lateral to the membrane.

Laryngoceles that were considered external were included in the combined group for this review, given that all laryngoceles originate from the internal structure of the saccule.

The combined approach involved internal endoscopic laser resection, with a variety of open surgical approaches including a midline transcervical incision or V-shaped lateral thyrotomy.

Seven studies, including five case reports and two case series, examined the use of robotic surgery, including transoral robotic surgery (TORS) for the removal of a combined laryngocele.

Most reported cases (45%) resected by TORS were combined laryngoceles, with no reported recurrences in any cases of combined laryngocele managed by TORS, up to 3 years after treatment.

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