Bilateral internal laryngoceles mimicking asthma
A 43-year-old male admitted to the pulmonology clinic of Acibadem Healthw Care Group, Acibadem Masalk Hospital, Istanbul, Turkey, in 2011, with dyspnea, cough, and excessive phlegm for a month and a late onset stridor. The patient had a history of asthma and he had been treated as asthma for 4 years. The response of the patient to antiasthmatic drugs was not sufficient and asthmatic attacks were frequent. A bronchoscopy was performed and upper airway obstruction was detected. Atalectatic bronchial segments were found. Sixth bronchi of the right inferior lung lobe was totally obstructed. The patient was referred to the Ear Nose and Throat (ENT) Clinic for upper airway evaluation. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized properly [Figures -]. Supraglottic area was narrow. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Hypodense areas causing expansion at the level of aryepiglottic folds were detected [Figures and ]. Endolaryngeal laser surgery was done under general anesthesia. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Airway was open and true vocal folds were visible during the postoperative endoscopic laryngeal examinations of the patient [Figures -, ]. The patient did not experience any respiratory event during the follow-up period after surgery. His last visit, free of symptoms, was at the sixth postoperative month.