Bilateral laryngocele with unilateral laryngopyocele: a case report and review of the literature

Abstract Background Laryngocele is a rare condition, and bilateral forms are exceptionally uncommon. The coexistence of laryngopyocele with a contralateral laryngocele presents both diagnostic and therapeutic challenges. Case report We report a 48-year-old male presenting with right-sided neck swelling and dysphagia. Initial clinical findings suggested a deep neck infection. However, contrast-enhanced CT revealed bilateral laryngoceles. On the right side, a combined laryngopyocele was identified, characterized by a distinct air–fluid level, which is a key radiological feature distinguishing laryngopyocele from a simple laryngocele. The left side showed an internal laryngocele. Following resolution of the acute inflammatory phase, surgical excision of the symptomatic laryngopyocele was performed via a transcervical approach with lateral thyrotomy. The asymptomatic contralateral laryngocele was managed conservatively. The patient had an uneventful recovery with preserved voice and swallowing function, and no recurrence was observed at one-year follow-up. Conclusion This case highlights the diagnostic challenge of laryngopyocele and underscores the importance of individualized management in bilateral laryngocele. Surgical intervention is indicated for symptomatic lesions, whereas asymptomatic laryngoceles may be safely managed with observation.