Laryngopyocoele: Simple Management of an Acute Airway Crisis

J Laryngol Otol. 2009 Feb;123(2):248-9. doi: 10.1017/S0022215108002417. Epub 2008 Apr 28.

Abstract

Objective: We present the first reported case of ultrasound-guided aspiration of a laryngopyocoele in a patient with acute airway obstruction.

Case report: A 71-year-old woman was diagnosed with a right-sided laryngocoele. Six weeks later, the patient was admitted as an emergency with a three-day history of increasing dyspnoea and stridor. Neck examination revealed a large, right-sided, soft neck mass, centred at level III, measuring approximately 10 x 5 cm. Fibre-optic laryngoscopy revealed a large, smooth, inflamed, right supraglottic mass obscuring the laryngeal inlet. The patient was taken directly to the radiology department, where ultrasound imaging confirmed a laryngopyocoele. Under ultrasound guidance, a 21-G needle was directed into the cyst and 30 ml of pus was aspirated. The dysphonia and stridor resolved immediately. Six weeks later, the patient underwent definitive surgical excision of the laryngocoele.

Conclusion: Laryngopyocoele is a rare diagnosis. It can present as an acute airway emergency. We present the first reported case managed by ultrasound-guided aspiration, which averted the need for endotracheal intubation or tracheostomy.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Airway Obstruction / diagnostic imaging
  • Airway Obstruction / etiology
  • Airway Obstruction / surgery*
  • Cysts / complications
  • Cysts / diagnostic imaging
  • Cysts / surgery*
  • Dyspnea / complications
  • Dyspnea / diagnostic imaging
  • Dyspnea / surgery*
  • Female
  • Humans
  • Laryngeal Diseases / complications
  • Laryngeal Diseases / diagnostic imaging
  • Laryngeal Diseases / surgery*
  • Radiography
  • Respiratory Sounds
  • Ultrasonography, Interventional