The laryngeal saccule — the small appendix of the laryngeal ventricle — can develop a retention cyst that progressively enlarges and distorts the supraglottic anatomy. Unlike an infection or a tumor, the cyst produces no dramatic event to mark its beginning: it simply grows, gradually and silently, until the anatomy around it is displaced.
Symptoms and Presentation
As the cyst expands it compresses surrounding structures. In adults this produces progressive hoarseness, a muffled or low voice quality, and a persistent sense of something in the throat. In neonates, a saccular cyst is a life-threatening emergency: the mass can occlude the airway entirely from birth, presenting as stridor or respiratory distress requiring immediate intervention.
Treatment
Treatment is endoscopic deroofing or excision. The cyst wall is opened and marsupialized so that it cannot re-accumulate fluid; in some cases the entire cyst is removed. Recurrence is uncommon after complete removal.
What you learned
- The laryngeal saccule is a small pouch opening off the laryngeal ventricle; it can develop a retention cyst that enlarges slowly and without symptoms until anatomy is displaced.
- In adults the main symptoms are progressive hoarseness and a sensation of something in the throat.
- In newborns a saccular cyst can occlude the airway entirely at birth — a true airway emergency requiring immediate endoscopic drainage.
- Treatment is endoscopic deroofing or excision; recurrence after complete removal is uncommon.