台耳醫誌

Laryngocele is a rare benign dilation of the laryngeal saccule. Among its subtypes, external laryngoceles are uncommon and may pose diagnostic challenges, particularly when presenting without characteristic laryngeal symptoms. The coexistence of an external laryngocele and multiple epiglottic cysts is exceptionally rare and may further obscure clinical recognition. We report a 74-year-old man with a 54-pack-year smoking history who experienced a 10-year history of intermittent dull chest pain radiating to the upper back, along with chronic cough and chest discomfort, but no typical laryngeal symptoms. Chest contrast-enhanced computed tomography (CECT), intended to exclude aortic dissection, revealed an external type laryngocele. Video Laryngoscopy revealed unremarkable in endolarynx except epiglottic cysts. External excision of the laryngocele was performed successfully, without internal component observed. Followup head and neck computed tomography (CT) showed no recurrence two months after surgery, and patient’s symptoms improved. This case broadens the clinical spectrum of laryngocele presentations and highlights the diagnostic importance of imaging— particularly CT—in evaluating atypical lesions. Clinicians should maintain vigilance for head and neck pathology in patients with unexplained chronic chest discomfort when cardiopulmonary causes are excluded. (J Taiwan Otolaryngol Head Neck Surg 2026; 60:139-144)