LARINGOTSELE (laryngocele; grech, larynx, laryng[os] a throat + kele a tumor) — the sacculate protrusion developing from ventricles of a throat or their shoots. Conditionally L. call an air tumor, an air cyst of a throat. Development of L. it is caused by two factors — the disturbance of conditions of the message between a throat and a cavity of a ventricle of a throat and also expressed by increase in endolaryngeal pressure, a cut it is more often observed at severe persistent cough, shout, playing wind instruments, blowing of glass products.
Pathogenetic distinguish true, false and symptomatic L. Pervye arise as manifestation of inborn features of a ventricle of a throat. False L. — the trapped air on a neck which is formed as a result of ulcer process or fistula in a thyroid cartilage through which air from a throat gets into soft tissues of a neck. At symptomatic L. as a result of development of a valve mechanism (at the expense of a tumor, hems, an immovability of one of voice folds) air gets into a ventricle of a throat and, without having an exit, inflates it.
The wall of a bag consists of fibrous connecting fabric. It is covered by a multirow cylindrical ciliary epithelium inside, under the Crimea diffusion accumulation of lymphocytes, sometimes in the form of follicles is noted. In places there are mucous glands, their output channels open in a cavity of L. Regarding cases the bag can be executed not by air, but serous liquid (laringogidrotsela).
On an arrangement distinguish internal, outside and combined by L.
At internal L. the bag extends in thickness of a fold of a threshold, sometimes reaching a cherpalonadgortanny sheaf (see. Throat ). Disturbances of phonation are noted, at the considerable amount of education — the phenomena acute or hron, a stenosis of a throat (see. Laryngostenosis ). At laringoskopiya (see) education is defined rounded shape, a cut it is located in the thickness of a fold of a vestibule of the larynx, sometimes reaches a cherpalonadgortanny sheaf and covers a voice fold. Education is elastic that is defined during the sounding, it is covered with not changed mucous membrane. At rentgenol, a research (usual roentgenograms and tomograms) in the field of a fold of a threshold and a ventricle of a throat pneumatic education, shaped hemispheres, with smooth contours is visible.
At outside L. the bag gets through a thyroid and hypoglossal membrane and extends between muscles of a neck. At the patient contours of a neck (the swelling appears) change, difficulty at inclinations and turns of the head is in some cases noted. Outside L. is located in an upper part of a neck, a knutra from grudino - a clavicular and mastoidal muscle where the elastic painless swelling of rounded shape is probed. Education is covered with not changed skin. It is closely connected with a throat — during the swallowing moves together with it. The amount of education is various — from 2 — 3 to 6 — 7 cm. In one cases of L. has the constant sizes, in others — increases at cough and a natuzhivaniye. Regarding cases of L. is defined only at increase in endolaryngeal pressure. During the pressing it can decrease in sizes or even to disappear (there is an air). Sometimes it is followed by the hissing sound. At percussion the tympanic sound is defined. At rentgenol, a research in soft tissues of a neck the cavity containing air is defined.
Combined by L. represents a combination of outside and internal L. also is followed by symptoms inherent in them.
At suppuration of L. sharp pain at the movements of the head, swallowing and phonation is noted, fervescence, the expressed hyperemia and morbidity of sacculate protrusion. Suppuration of internal L. can be followed by an acute stenosis of a throat.
A number of authors allocates other forms to a laringotsela: L. a lingual and epiglottidean pole (vallekula) at which the trapped air is implemented between an epiglottis and a hypoglossal bone and at the level of a vallekula comes to an end; L. subhypoglossal when the trapped air is implemented between maxillary and hypoglossal and genioglossal muscles and extends under a horizontal branch of a mandible. Outside side L., being continuation of a shoot of a ventricle of a throat, gets through a shchitovidnopodjyazychny membrane and it is localized on the lateral surface of a neck. At outside median L. protrusion of a mucous membrane of a ventricle of a throat happens up, to the level of a front corner of a thyroid cartilage, according to a thyroid and hypoglossal membrane or down, to the area of a cricoid. 10. B. Preobrazhensky (1961) distinguishes also atypically extending L.
Diagnosis is helped by a puncture of a bag, at a cut there is a release of air (or liquid contents) and sharp reduction of L. in sizes.
Treatment — operational, consists in full removal of a bag. At outside L. operation is made with an outside section, at internal — do a laryngofissure (see. Laryngotomy ), through to-ruyu stupid and an acute way delete a bag in some cases using a galvanocautery. At L., followed by the phenomena of an acute stenosis of a throat, first of all make a konikotomiya or tracheostomy (see).
Bibliography: Iskhaki Yu. B. Cysts of upper respiratory tracts, Dushanbe, 1972; To at l and N about in and P. S. O air tumors of a throat, Vestn, otorino-lar., No. 1, page 34, 1950, bibliogr.; Nathan with about L. N. N and P and with p about p about in A. P. O air tumors of a throat and neck (laryngocele vera, symptomatica spuria), Zhurn, ushn., Nov. and throats, Bol., t. 7, No. 10, page 548, 1930, bibliogr.; P r e about r azhensky Yu. B. K to a question about atypically extending to a laringotsela, in the same place, No. 2, page 46, 1961; Canalis R. F., Maxwell D. S. a. Heme n way W. C. Laryngocele — an updated review, J. Otolaryng. (Toronto), v. 6, p. 191, 1977; M about 1 1 i with a V. II laringocele, Minerva otorinolaring., v. 8, p. 493, 1958; Rendu R. Laryngocele et anatomic compare, Rev. Laryng. (Bordeaux), t. 60, p. 501, 1939.
Yu. B. Preobrazhensky.