Lethal Laryngopyocele

Abstract

A 44-year-old man collapsed after complaining of difficulty breathing. Layer dissection of the neck at autopsy revealed a large mixed internal and external laryngopyocele occluding the upper airway. It contained 30 mls of yellow-gray pus. Mechanisms of death in laryngoceles involve obstruction of the opening into the larynx resulting in accumulation of mucus or air within the sac causing airway occlusion. Once infection supervenes, deaths in laryngopyocoeles result either from accumulated pus causing airway occlusion from a mass effect (as in the current case) or the discharge of pus into the airway causing death from aspiration. Sudden death in laryngopyoceles is a very rare event that requires careful dissection at autopsy to demonstrate the characteristics of the underlying lesion and the possible mechanism of death. Laryngopyocele should be considered in the differential diagnosis of natural conditions causing acute, potentially lethal, upper airway obstruction.

Laryngopyocele in a case of bilateral mixed laryngocele: an impending airway emergency

“…Laryngopyoceles can be life-threatening and four cases of mortality have been reported in literature 9. The probable causes for death in laryngopyocele are laryngeal inlet obstruction because of mass effect of the pyocele itself or discharge of pus into the larynx causing aspiration.…”

A Rare Cause of Acute Airway Obstruction: The Mixed Laryngopyocele

“…The precise aetiology of laryngocele is unknown but association with laryngeal malignancies, essentially supra-glottic laryngeal tumours, was described (6) The CT scan is also essential in making the differential diagnosis between laryngopyocele and other neoformations such as lipoma, paraganglioma, schwannoma, cystic lymphangioma, thyroglottic duct cysts, branchial cysts, epiglottic abscess and metastatic adenopathy (2,4).…”

“…In less than 10% of cases, the laryngocele is infected and become a laryngopyocele (2). The laryngopyocele is a life-threatening mass by leading rapid and complete obstruction of the airway (4,3).…”

Internal Laryngocele: Unusual onset in a 91-year-old female patient

“…While this occurs rarely, this severe condition can present with acute airway obstruction and sepsis and may be fatal. 3 While most laryngoceles are asymptomatic, symptoms can vary according to the type of laryngocele. External laryngoceles usually present as a neck mass that can mimic a neck abscess, lymphadenopathy and saccular, branchial or thyroglossal cysts.…”