Terminology, Definitions, and Classification in the Imaging of Laryngoceles

Objective: We aim to better define the anatomy, criteria, and classification of laryngoceles, and to raise the awareness to potential mimickers and anatomical variants leading to misdiagnosis. Methods: A retrospective review of all computed tomography studies, performed over a decade, with the diagnosis of “laryngocele” in the radiological report in a tertiary medical center. All relevant studies were reviewed by two independent readers for the presence of true laryngoceles. Results: One hundred and twelve patients were included; average age was 54 (±18). Re-read of scans with 3D reconstructions resulted in detecting 58 (52%) true laryngoceles, with 19.5% bilateral laryngoceles. Anatomical variants and laryngocele mimickers formerly misdiagnosed as laryngoceles included 26/54 (48%) prominent ventricles, 19/54 (35%) saccules not meeting criteria for laryngocele, 8/54 (15%) prominent pyriform sinuses and one tracheal diverticulum. Conclusions: Intimate knowledge of the laryngeal anatomy, the criteria for a laryngocele and anatomical variants as well mimickers, is the key to avoid radiological misdiagnosis.