The differential diagnosis of cystic swelling in the upper part of the neck should include TDC, branchial cyst, submandibular salivary gland duct cyst, cystic hygroma, saccular cyst, mucous retention cyst, laryngocele and jugular vein phlebectasia, and pharyngocele
The differential diagnosis includes laryngocele, pharyngocele
, branchial or superior mediastinal cyst, pulmonary apical bulla and, less commonly, a vascular malformation.
also presents as a cystic swelling in the upper part of the neck.
The differential diagnosis of a paratracheal air collection includes pharyngocele
, esophageal diverticulum, laryngocele, apical lung hernia, and apical paraseptal blebs, or bullae.
On flexible laryngoscopy, a small left pharyngocele was seen at the thyrohyoid membrane just above the thyroid cartilage and piriform fossa (figure, A).
Several options were discussed with the patient, including observation, swallowing therapy, percutaneous augmentation of the pharyngocele, and open surgical excision.
Pharyngocele, or lateral pharyngeal diverticulum (LPD), is rare, as only a few cases have been described.
1,2) The first well-documented case of a pharyngocele was reported by Wheeler (3) in 1886, and the first roentgenographic study of a pharyngocele was published by Hankins (4) in 1944.
Differentiating a pharyngocele
from a laryngocele can be difficult given that both entities appear clinically in a similar manner.
Ward, and in our paper) of laryngocele and pharyngocele
remain valid, combinations of both can occur.
In our review of the medical literature, we found a number of case reports with unusual presentations of BAs, including retropharyngeal abscesses, (2,3) pharyngoceles
, (4) duplicate ossicles, (5) intrathryoidal lesions, (6-8) an epiglottic cyst, (9) and 2 cases of pharyngeal branchial cysts involving the tonsil.
In a LETTER TO THE EDITOR in the March issue of EAR, NOSE, AND THROAT JOURNAL, a comment was made regarding the differentiation between laryngoceles and pharyngoceles