Laryngocoele, laryngocele - Vula - University of Cape Town
Laryngocoele, laryngocele - Vula - University of Cape Town
Laryngocoele, laryngocele - Vula - University of Cape Town
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SLNSLASTAAdminister 24hrs’ perioperative antibioticsshould mucosa be breachedInsert a suction/pencil/corrugated drainand close the woundBecause mucosal defects would besupraglottic, postoperative surgical emphysemaand airway obstruction areunusualInternal cystNeckFigure 17: Identify the superior laryngealnerve (SLN) where it emergesdeep to the superior thyroid arteryExternal cystSLASLNSTAThyroidFigure 19: Free cyst from the superiorlaryngeal artery (SLA), superior laryngealnerve (SLN) and deliver it fromparaglottic spaceThyrohyoidOmohyoidFigure 18: Retract omohyoid andthyrohyoid muscles to expose top edge<strong>of</strong> thyroid cartilageSLNSLASTAFree the cyst from the perichondriumon the medial aspect <strong>of</strong> the thyroidlamina, and deliver it from the paraglotticspace. Carefully peel the cyst<strong>of</strong>f the internal branch <strong>of</strong> the superiorlaryngeal nerve and from the mucosaoverlying the medial aspect <strong>of</strong> the aryepiglotticfold, and deliver the cyst(Figures 19, 20)Inspect the wound for tears or breachesin the mucosa which, if present, arerepaired with absorbable suturesFigure 20: Final view <strong>of</strong> key structuresTo gain additional exposure to the internalcomponent <strong>of</strong> the cyst in the paraglotticspaceIncise the thyroid perichondrium alongthe superior and posterior margins <strong>of</strong>the thyroid lamina (Figure 21)6
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