Potential Causative Factors for Saccular Disorders: Association with Smoking and Other Laryngeal Pathologies

J Voice. 2017 Sep;31(5):621-627. doi: 10.1016/j.jvoice.2017.01.004. Epub 2017 May 2.

Abstract

Objective: To describe risk factors, clinical presentation, and outcome of patients with saccular disorders.

Study design: Case control with chart review METHODS: A single center retrospective study. Case group included all adult patients, presenting with saccular disorders (saccular cyst or laryngocele), between the years 2010 and 2015. A matched group of patients with vocal fold cyst served as the control.

Results: Twenty-nine patients met the inclusion criteria: 15 males and 14 females; the mean age was 60.5(±11.2). The median follow-up period was 10 months (range 2-48). Overall, 75.9% (22) had a positive smoking history; 55.2% (16) were active and 20.7% (6) were past smokers. The median pack- years of all smokers in the saccular disorder group was 40 (range 1-67). Saccular disorder patients demonstrated significantly higher prevalence of active smoking when compared to control patients (55.2% versus 17.9%, P = 0.014). Sixty-nine percent of the patients had some synchronous vocal fold comorbidity. The leading vocal fold comorbidity was Reinke's edema in 41% (12). Synchronous vocal fold comorbidities were significantly more prevalent in smokers compared with nonsmokers-82% (18 of 22) and 29% (2 of 7), respectively (P = 0.008). Surgical treatment was performed on 26 patients; all of whom underwent complete resection, either by endoscopic (92%), external (4%), or combined external and endoscopic (4%) approaches. There was a single case of recurrence (4%), 10 months following initial resection.

Conclusion: Saccular disorders are associated with smoking and synchronous vocal fold comorbidity. Complete resection is recommended as surgical outcome is excellent.

Keywords: Endoscopic; Laryngocele; Saccular; Smoking; Vocal folds.

MeSH terms

  • Aged
  • Comorbidity
  • Cysts / diagnosis
  • Cysts / epidemiology*
  • Cysts / physiopathology
  • Cysts / surgery
  • Female
  • Humans
  • Israel / epidemiology
  • Laryngeal Diseases / diagnosis
  • Laryngeal Diseases / epidemiology*
  • Laryngeal Diseases / physiopathology
  • Laryngeal Diseases / surgery
  • Laryngectomy
  • Laryngocele / diagnosis
  • Laryngocele / epidemiology*
  • Laryngocele / physiopathology
  • Laryngocele / surgery
  • Laryngoscopy
  • Male
  • Middle Aged
  • Prevalence
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology*
  • Time Factors
  • Treatment Outcome
  • Vocal Cords / physiopathology
  • Vocal Cords / surgery
  • Voice Disorders / diagnosis
  • Voice Disorders / epidemiology*
  • Voice Disorders / physiopathology
  • Voice Disorders / surgery
  • Voice Quality