Combined Internal-External Laryngocele Successfully Treated by a One-Stage Surgical Procedure

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Abstract
Combined internal-external laryngocele is very rare. Taylor1 in 1944 stated that in the 66-year period of the Academy meetings only one case was presented. The external variety is most prevalent. A review of the literature by O'Keefe2 for the period 1940-1949 revealed 14 reported cases; 10 were of the external variety and 4 of the internal variety. Over-all total to date is about 75 cases. In reviewing the literature one encounters numerous surgical techniques in the treatment of the internal and the combined varieties of laryngocele. As for the external variety, the consensus is excision of the sac through a lateral neck incision, the stalk being amputated at the level of the thyrohyoid membrane. It has been customary to approach the internal variety through either a laryngofissure or a lateral thyrotomy. Most surgeons prefer to remove the posterior third of the thyroid cartilage to get a wider exposure. O'Keefe3 in

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