Laryngocele
in an Infant
By P. R. Walpita Colombo,
Sri Lanka
Only eight cases of laryngoceles have been reported in infants; Hollinger described two types of laryngoceles, external and internal.’ In the adult, laryngoceles have been reported in glass-blowers and in musicians playing wind instruments.’ In infants, however, the M., a 2-mo-old female weighing 5 of the neck, which was present from cried. A radiologic study showed air erect film (Fig. 1). While awaiting surgery, the infant
pathogenesis is speculative. kg, presented with a soft nontender swelling in the left side birth. The swelling appeared to increase in size when she in front of the tracheal air shadow and a fluid level in the developed
upper
respiratory
tract
infection.
With
the sub-
sidence of the acute phase of the respiratory infection, the swelling became tense and tender and was associated with respiratory distress. The infant was then taken for surgery. Through a transverse skin incision in the neck, a cystic swelling-oval in shape with a pedicle arising from between the hyoid bone and the thyroid cartilage, a little to the left of the midline and pushing the cervical muscles outward-was exposed. This was easily excised in toto after ligating the pedicle. It was not found necessary to go into the larynx. The wound was closed in layers with drainage. The cyst contained semipurulent fluid, and the lumen of the pedicle was found to have been occluded. Her postoperative course was uneventful, and the infant was dis-
Fig. 1. X-ray showing pretracheal air shadow with a fluid level.
0 1975
by Grune
Journal of Pediatric
& Stratton,
Surgery,
Inc.
Vol. 10, No. 5 (October), 1975
843
CASE REPORTS
044
charged from the hospital on the 9th showed an uncomplicated recovery.
postoperative
day.
Subsequent
follow-up
at the
clinic
DISCUSSION A cystic neck swelling in this infant proved on x-ray film to be a laryngocele. She was symptom free until an attack of upper respiratory tract infection produced infection in the laryngocele and respiratory distress. Being a purely external type, the laryngocele was readily accessible through a skin incision in the neck and easily excisable, since it was well pedunculated: the laryngocele had merely pushed the overlying structures outward. REFERENCES I. Hollinger PH: Clinical aspects of congenital anomalies of the larynx, trachea, bronchi and oesophagus.
J Laryngol
Otol75:
1, 1961
2. Thawley Laryngoscope
SE, Bone RC: 83:362, 1973
Laryngopyocoele.
in an Infant
By P. R. Walpita Colombo,
Sri Lanka
Only eight cases of laryngoceles have been reported in infants; Hollinger described two types of laryngoceles, external and internal.’ In the adult, laryngoceles have been reported in glass-blowers and in musicians playing wind instruments.’ In infants, however, the M., a 2-mo-old female weighing 5 of the neck, which was present from cried. A radiologic study showed air erect film (Fig. 1). While awaiting surgery, the infant
pathogenesis is speculative. kg, presented with a soft nontender swelling in the left side birth. The swelling appeared to increase in size when she in front of the tracheal air shadow and a fluid level in the developed
upper
respiratory
tract
infection.
With
the sub-
sidence of the acute phase of the respiratory infection, the swelling became tense and tender and was associated with respiratory distress. The infant was then taken for surgery. Through a transverse skin incision in the neck, a cystic swelling-oval in shape with a pedicle arising from between the hyoid bone and the thyroid cartilage, a little to the left of the midline and pushing the cervical muscles outward-was exposed. This was easily excised in toto after ligating the pedicle. It was not found necessary to go into the larynx. The wound was closed in layers with drainage. The cyst contained semipurulent fluid, and the lumen of the pedicle was found to have been occluded. Her postoperative course was uneventful, and the infant was dis-
Fig. 1. X-ray showing pretracheal air shadow with a fluid level.
0 1975
by Grune
Journal of Pediatric
& Stratton,
Surgery,
Inc.
Vol. 10, No. 5 (October), 1975
843
CASE REPORTS
044
charged from the hospital on the 9th showed an uncomplicated recovery.
postoperative
day.
Subsequent
follow-up
at the
clinic
DISCUSSION A cystic neck swelling in this infant proved on x-ray film to be a laryngocele. She was symptom free until an attack of upper respiratory tract infection produced infection in the laryngocele and respiratory distress. Being a purely external type, the laryngocele was readily accessible through a skin incision in the neck and easily excisable, since it was well pedunculated: the laryngocele had merely pushed the overlying structures outward. REFERENCES I. Hollinger PH: Clinical aspects of congenital anomalies of the larynx, trachea, bronchi and oesophagus.
J Laryngol
Otol75:
1, 1961
2. Thawley Laryngoscope
SE, Bone RC: 83:362, 1973
Laryngopyocoele.
