Kelainan Kongenital The saccule is a diverticulum of mucous membrane which starts from the anterior part of ventricular cavity and extends upwards between vestibular folds and lamina of thyroid cartilage.

When abnormally enlarged and distended, it may form a laryngocele—an air containing sac which may present in the neck. There are many mucous glands in the saccule, which help to lubricate the vocal cords.

Laryngocele. It is dilatation of laryngeal saccule and extends between thyroid cartilage and the ventricle. It may be internal, external or combined. Treatment is endoscopic or external excision.

Laryngocele. It is an air-filled cystic swelling due to dilata- tion of the saccule (Figure 61.5). A laryngocele may be:

(a) Internal which is confined within the larynx and pres- ents as distension of false cord and aryepiglottic fold.

(b) External in which distended saccule herniates through the thyroid membrane and presents in neck.

(c) Combined or mixed in which both internal and external components are seen.

A laryngocele is supposed to arise from raised transglottic air pressure as in trumpet players, glass-blowers or weight lifters.

A laryngocele presents with hoarseness, cough and if large, obstruction to the airway. An external laryngocele presents as a reducible swelling in the neck which increases in size on coughing or performing Valsalva (Figure 61.6).

Diagnosis can be made by indirect laryngoscopy, and soft tissue AP and lateral views of neck with Valsalva. CT scan helps to find the extent of lesion.

Treatment is surgical excision through an external neck incision. Marsupialization of an internal laryngocele can be done by laryngoscopy but there are chances of recurrence.

A laryngocele in an adult may be associated with carci- noma which causes obstruction of saccule.