A 30-year-old man notices a soft swelling over the right side of his neck that increases in size when he blows a trumpet or strains, and decreases with pressure. He also reports intermittent muffled voice. CT shows an air-filled sac arising from the laryngeal ventricle extending through the thyrohyoid membrane. The diagnosis is:
- A Branchial cyst
- B External laryngocele ✓
- C Saccular cyst
- D Thyroglossal duct cyst
Correct answer: B. External laryngocele
Explanation
B laryngocele is an abnormal dilatation of the saccule of the ventricle filled with air. When it extends beyond the thyrohyoid membrane into the neck it is called an external or mixed laryngocele, characteristically enlarging with raised intralaryngeal pressure such as trumpet playing, glass blowing or straining. B saccular cyst is fluid filled and stays internal, while branchial and thyroglossal cysts do not communicate with the ventricle or vary with Valsalva.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.