Laryngoceles with airway compromise complicating mucous membrane pemphigoid.

Mucous membrane pemphigoid (MMP) encompasses a group of autoantibody-mediated, subepithelial blistering diseases, which primarily affect mucosal surfaces including oral, ocular, skin, genital, nasopharyngeal and oesophageal sites. We present a first description of laryngoceles as a manifestation of mucous membrane pemphigoid resulting in dynamic airway closure. Mucosal injury at other sites had previously resulted in pathergy and localised cicatrisation. We discuss successful combined medical and transcutaneous surgical intervention designed to avoid tracheostomy and minimise iatrogenic laryngeal cicatrisation.

[Dyspnoea revealing laryngopyocele]. / Une dyspnée révélant une laryngopyocèle.

Laryngocele is rare; it is an abnormal dilatation of the laryngeal appendix or of the Morgagni's ventricular pouch. Its size is variable. When it is small, it is usually asymptomatic. When it is large, it can manifest as a cervical anterolateral paralaryngeal mass. Diagnosis is based on CT scan. Treatment approach is still discussed. Endoscopic CO2 laser treatment has aroused great interest in recent years. We here report the clinical observation of a 24-year old woman with a 4-year history of intermittent dyspnea. Endoscopic examination showed an increase in the bulge of the right ventricular band associated with arytenoid oedema. Cervical CT scan with contrast medium objectified well-defined, hypodense collection next to the right thyroid cartilage, contrast enhanced in the periphery without bone lysis or lysis of the cartilage. It pressed the vallecula left with discreet infiltration of the surrounding grease. The diagnosis of internal laryngopyocele was suspected, confirming the clinical data. The patient was treated with antibiotics and corticosteroids before cervicotomy since it was not possible to perform endoscopic marsupialisation due to non-availability of the laser.