Potential Causative Factors for Saccular Disorders: Association with Smoking and Other Laryngeal Pathologies

SummaryObjectiveTo describe risk factors, clinical presentation, and outcome of patients with saccular disorders.Study DesignCase control with chart reviewMethodsA single center retrospective study. Case group included all adult patients, presenting with saccular disorders (saccular cyst or laryngocele), between the years 2010 and 2015. A matched group of patients with vocal fold cyst served as the control.ResultsTwenty-nine patients met the inclusion criteria: 15 males and 14 females; the mean age was 60.5(±11.2). The median follow-up period was 10 months (range 2-48). Overall, 75.9% (22) had a positive smoking history; 55.2% (16) were active and 20.7% (6) were past smokers. The median pack- years of all smokers in the saccular disorder group was 40 (range 1-67). Saccular disorder patients demonstrated significantly higher prevalence of active smoking when compared to control patients (55.2% versus 17.9%, P = 0.014).Sixty-nine percent of the patients had some synchronous vocal fold comorbidity. The leading vocal fold comorbidity was Reinke's edema in 41% (12). Synchronous vocal fold comorbidities were significantly more prevalent in smokers compared with nonsmokers-82% (18 of 22) and 29% (2 of 7), respectively (P = 0.008).Surgical treatment was performed on 26 patients; all of whom underwent complete resection, either by endoscopic (92%), external (4%), or combined external and endoscopic (4%) approaches. There was a single case of recurrence (4%), 10 months following initial resection.ConclusionSaccular disorders are associated with smoking and synchronous vocal fold comorbidity. Complete resection is recommended as surgical outcome is excellent.