Clinical Staging of Combined Laryngoceles: A Novel Concept

Background: Virchow described laryngocele for the first time in 1867 as a herniation of the laryngeal ventricle or “laryngocele ventricularis”, while Dominique Larrey used the term “goitre aeriennes” to describe the condition in a case for the first time. Aim: To achieve precise clinical staging ofcombined laryngoceles based onanatomical internal extension. This aim was achieved by analyzing our case series and by validating this staging system (correlating between patient complaint, endoscopic, and imaging findings). Patients and methods: This retrospective study included a total of 24 cases with combined laryngoceles admitted to the Otorhinolaryngology Department, Mansoura University hospital, Mansoura, Egypt between 1998 to 2022. Results:The study found that all cases had an external component detected. There were 16 cases with V1 grade (ventricle), 66.7% with V2 grade (ventricle and vestibule), and 16.7% with V3 grade (ventricle with vestibule and vallecula). There was no significant difference in dysphonia, aerodigestive obstruction, and dysphagia between cases with and without air content. However, cases with air content had a higher incidence of stridor and dyspnea. No significant difference was found in endoscopic grading based on air content within the laryngocele. Conclusion:Clinical staging of combined laryngoceles (V1, V2, V3) is a simple, feasible, and reliable method validated clinically, endoscopically, and radiologically, avoiding bias.