SACCULAR CYST//LARYNGOCELE//LARYNGEAL CYST DIFFERENCE скачать в хорошем качестве

SACCULAR CYST//LARYNGOCELE//LARYNGEAL CYST DIFFERENCE

Saccular cysts, laryngoceles, and laryngeal cysts are rare but clinically significant conditions of the larynx. Understanding their differences is crucial for accurate diagnosis and management. 1. Saccular Cysts: A saccular cyst is an air- or fluid-filled sac that originates from the saccule of the laryngeal ventricle. These cysts are classified into two types: • Internal saccular cysts, which remain within the laryngeal structure. • External saccular cysts, which extend beyond the laryngeal framework. Saccular cysts may present with symptoms like hoarseness, stridor, or airway obstruction, depending on their size and location. Diagnosis is often confirmed using laryngoscopy and imaging like CT or MRI. Management involves: • Surgical excision via direct laryngoscopy. • Marsupialization is an alternative technique where the cyst is opened and the edges are sutured to create a permanent opening, allowing continuous drainage and preventing recurrence. • Microdebriders or laser techniques are sometimes used to reduce recurrence. • External approaches, such as a lateral neck incision, may be necessary for large, externally extending cysts. 2. Laryngocele: A laryngocele is an abnormal dilation of the laryngeal saccule, containing air, and it communicates with the laryngeal lumen. It can be classified into: • Internal laryngocele: Remains within the larynx. • External laryngocele: Extends through the thyrohyoid membrane and appears as a neck mass. • Mixed laryngocele: Combines features of both, presenting with both intralaryngeal and extralaryngeal components. Laryngoceles are often asymptomatic but can cause hoarseness, cough, or a neck swelling that increases with Valsalva maneuver. Imaging with CT or MRI is key for differentiating a laryngocele from other neck masses. Management includes: • Endoscopic CO2 laser excision for internal laryngoceles. • An external approach may be needed for large, external laryngoceles to ensure complete excision. • In cases of infection, called laryngopyocele, antibiotics are administered first, followed by surgical drainage. 3. Laryngeal Cysts: These are benign cystic lesions of the larynx that can occur in various locations, such as the epiglottis, vocal cords, or aryepiglottic folds. Laryngeal cysts are classified into: • Retention cysts: Result from blockage of mucosal glands. • Epidermoid cysts: Arise from epithelial cells. • Ductal cysts: Develop from the dilation of ducts. They often present with voice changes, dyspnea, or a sensation of a foreign body. Laryngoscopy and imaging help in diagnosis. Management involves: • Micro-laryngoscopic excision using cold steel instruments or lasers. • Careful dissection is necessary to avoid damage to surrounding structures, especially for vocal cord cysts to preserve phonation. • Recurrence is rare with complete removal, but incomplete excision may lead to regrowth. Conclusion: In summary, while saccular cysts, laryngoceles, and laryngeal cysts may present similarly, their origin, types, and management strategies differ significantly. Accurate diagnosis using laryngoscopy and imaging, followed by a tailored surgical approach, is crucial for effective treatment. Understanding these nuances is key for any aspiring ENT specialist or advanced medical student.”