Laryngeal saccules

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Laryngeal saccule
Gray954.png
A coronal section of the human larynx, showing the laryngeal saccules, labelled appendix of ventricle.
Details
System larynx
Identifiers
Latin sacculus laryngis
TA98 A06.2.09.011
TA2 3207
FMA 64172
Anatomical terminology

The laryngeal saccules are soft tissue masses that are extensions of the laryngeal ventricles in the larynx. Their function is not well understood, but they may lubricate the vocal cords, and increase the resonance of vocalisation. They may be involved in airway disease and airway obstruction. They may be surgically removed using a laryngeal sacculectomy.

Contents

Structure

The laryngeal saccules are extensions of the laryngeal ventricles as part of the lateral wall of the larynx. [1] They ascend posterior to the thyroid cartilage. [1] They are surrounded by loose areolar connective tissue. [1] This may contain lymphoid tissue, which is healthy in children and may be a sign of illness in adults. [1]

The laryngeal saccules have pseudostratified columnar epithelium, and contain many mucous glands. [1]

Function

The function of the laryngeal saccules is not well understood. [1] They may help to lubricate the vocal cords, with the contraction of surrounding muscles increasing mucus secretion. [1] In other animals (such as primates), they may increase the resonance of vocalisation. [1]

Clinical significance

The laryngeal saccules may become infected, or become a laryngocoele. [1] They may be assessed during laryngoscopy. [2]

Airway disease

Chronic airway obstruction (caused by stenotic nares, elongated soft palate, or other conditions) can evert the laryngeal saccules. [3] This may aggravate an existing breathing problem. Prolonged airway stress can pull laryngeal walls inward, further obstructing the airway and causing swelling and irritation of the laryngeal membranes. Tracheal collapse may also contribute to a cycle of airway obstruction and airway changes. [4]

In brachycephalic breeds of dog, the saccules can become everted and protrude into the laryngeal opening, causing symptoms such as snoring, noisy breathing, coughing, nasal congestion, and shortness of breath in affected dogs. [5]

Surgical removal

Laryngeal sacculectomy may involve snipping the saccules out with scissors or snaring them with a wire loop, [5] or the saccules may be removed with the use of a laser. [4] This allows a dog with airway disease to breathe better or normally. [5]

History

The laryngeal saccules may also be known as appendices of the laryngeal ventricles. [6] [7]

Related Research Articles

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The larynx, commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about 4–5 centimeters in diameter. The larynx houses the vocal cords, and manipulates pitch and volume, which is essential for phonation. It is situated just below where the tract of the pharynx splits into the trachea and the esophagus. The word 'larynx' comes from the Ancient Greek word lárunx ʻlarynx, gullet, throat.ʼ

<span class="mw-page-title-main">Tracheal intubation</span> Placement of a tube into the trachea

Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.

<span class="mw-page-title-main">Laryngoscopy</span> Endoscopy of the larynx

Laryngoscopy is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anaesthesia or cardiopulmonary resuscitation or for surgical procedures on the larynx or other parts of the upper tracheobronchial tree.

<span class="mw-page-title-main">Epiglottis</span> Leaf-shaped flap in the throat that prevents food from entering the windpipe and the lungs

The epiglottis is a leaf-shaped flap in the throat that prevents food and water from entering the trachea and the lungs. It stays open during breathing, allowing air into the larynx. During swallowing, it closes to prevent aspiration of food into the lungs, forcing the swallowed liquids or food to go along the esophagus toward the stomach instead. It is thus the valve that diverts passage to either the trachea or the esophagus.

<span class="mw-page-title-main">Laryngeal cancer</span> Medical condition

Laryngeal cancer or throat cancer is a kind of cancer that can develop in any part of the larynx. It is typically a squamous-cell carcinoma, reflecting its origin from the epithelium of the larynx.

<span class="mw-page-title-main">Laryngitis</span> Medical condition

Laryngitis is inflammation of the larynx. Symptoms often include a hoarse voice and may include fever, cough, pain in the front of the neck, and trouble swallowing. Typically, these last under two weeks.

<span class="mw-page-title-main">Airway management</span> Medical procedure ensuring an unobstructed airway

Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents (aspiration).

<span class="mw-page-title-main">Respiratory arrest</span> Medical condition

Respiratory arrest is a serious medical condition caused by apnea or respiratory dysfunction severe enough that it will not sustain the body. Prolonged apnea refers to a patient who has stopped breathing for a long period of time. If the heart muscle contraction is intact, the condition is known as respiratory arrest. An abrupt stop of pulmonary gas exchange lasting for more than five minutes may permanently damage vital organs, especially the brain. Lack of oxygen to the brain causes loss of consciousness. Brain injury is likely if respiratory arrest goes untreated for more than three minutes, and death is almost certain if more than five minutes.

<span class="mw-page-title-main">Norwich Terrier</span> Dog breed

The Norwich Terrier is a breed of dog originating in the United Kingdom, and was bred to hunt small rodents. With a friendly personality, Norwich Terriers are today mostly a companion dog breed. One of the smallest terriers, these dogs are generally healthy, but are relatively rare, due in part to their low litter size and the common need for caesarian sections. Their drop-eared variety is the Norfolk Terrier.

<span class="mw-page-title-main">Laryngeal papillomatosis</span> Medical condition

Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis (RRP) or glottal papillomatosis, is a rare medical condition in which benign tumors (papilloma) form along the aerodigestive tract. There are two variants based on the age of onset: juvenile and adult laryngeal papillomatosis. The tumors are caused by human papillomavirus (HPV) infection of the throat. The tumors may lead to narrowing of the airway, which may cause vocal changes or airway obstruction. Laryngeal papillomatosis is initially diagnosed through indirect laryngoscopy upon observation of growths on the larynx and can be confirmed through a biopsy. Treatment for laryngeal papillomatosis aims to remove the papillomas and limit their recurrence. Due to the recurrent nature of the virus, repeated treatments usually are needed. Laryngeal papillomatosis is primarily treated surgically, though supplemental nonsurgical and/or medical treatments may be considered in some cases. The evolution of laryngeal papillomatosis is highly variable. Though total recovery may be observed, it is often persistent despite treatment. The number of new cases of laryngeal papillomatosis cases is approximately 4.3 cases per 100,000 children and 1.8 cases per 100,000 adults annually.

<span class="mw-page-title-main">Cricothyroid ligament</span>

The cricothyroid ligament is a ligament in the neck. It connects the cricoid cartilage to the thyroid cartilage. It prevents these cartilages from moving too far apart. It is cut during an emergency cricothyrotomy to treat upper airway obstruction.

<span class="mw-page-title-main">Arytenoid cartilage</span> Part of the larynx, to which the vocal folds (vocal cords) are attached

The arytenoid cartilages are a pair of small three-sided pyramids which form part of the larynx. They are the site of attachment of the vocal cords. Each is pyramidal or ladle-shaped and has three surfaces, a base, and an apex. The arytenoid cartilages allow for movement of the vocal cords by articulating with the cricoid cartilage. They may be affected by arthritis, dislocations, or sclerosis.

<span class="mw-page-title-main">Laryngomalacia</span> Medical condition

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<span class="mw-page-title-main">Vestibular fold</span>

The vestibular fold is one of two thick folds of mucous membrane, each enclosing a narrow band of fibrous tissue, the vestibular ligament, which is attached in front to the angle of the thyroid cartilage immediately below the attachment of the epiglottis, and behind to the antero-lateral surface of the arytenoid cartilage, a short distance above the vocal process.

Bulbar palsy refers to a range of different signs and symptoms linked to impairment of function of the glossopharyngeal nerve, the vagus nerve, the accessory nerve, and the hypoglossal nerve. It is caused by a lower motor neuron lesion in the medulla oblongata, or from lesions to these nerves outside the brainstem, and also botulism. This may be caused by any of a number of genetic, vascular, degenerative, inflammatory, and other underlying conditions. It can be differentiated from pseudobulbar palsy. When there is airway obstruction, intubation is used.

<span class="mw-page-title-main">Brachycephalic airway obstructive syndrome</span> Condition affecting short-nosed dogs and cats

Brachycephalic airway obstructive syndrome (BAOS) is a pathological condition affecting short nosed dogs and cats which can lead to severe respiratory distress. There are four different anatomical abnormalities that contribute to the disease, all of which occur more commonly in brachycephalic breeds: an elongated soft palate, stenotic nares, a hypoplastic trachea, and everted laryngeal saccules. Because all of these components make it more difficult to breathe in situations of exercise, stress, or heat, an animal with these abnormalities may be unable to take deep or fast enough breaths to blow off carbon dioxide. This leads to distress and further increases respiratory rate and heart rate, creating a vicious cycle that can quickly lead to a life-threatening situation.

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Fading puppy syndrome is when a puppy dies within the first few weeks of life without a clear cause of death or clinical signs, that is to say, they fail to thrive. Death usually occurs within the first five days of life, but can happen up to ten weeks of age. It is responsible for about 50% of deaths of new-born puppies.

An elongated soft palate is a congenital hereditary disorder that negatively affect dogs and cats' breathing and eating. A soft palate is considered elongated when it extends past the top of the epiglottis and/or past the middle of the tonsillar crypts. The soft palate is made up of muscle and connective tissue located in the posterior portion on the roof of the mouth. The soft palate creates a barrier between the mouth and nose. This continuation between the cavities makes it possible to chew and breathe at the same time. The soft palate only blocks the nasal cavity while swallowing. At rest the soft palate should only stretch caudally from the hard palate to the tip of the epiglottis leaving an opening between the nasal and oral cavities. When the soft palate is elongated, it partially blocks the throat thereby creating breathing and feeding-related issues. The elongation and other accompanying symptoms occur in breeds characterized with “smooshed faces” such as pugs, bulldogs, and Persian cats. This condition is a congenital, meaning it is present when the animal is born. The “smooshed” characteristics is the result of a genetic mutation. The animal’s genetic code causes the bones in their skull to grow to a smaller size. Because the bones are smaller, muscles and other tissues that surround the bones of the skull are out of proportion. These animals are often referred to as brachycephalic, derived from the Greek words for “short” and “head”. An elongated soft palate is a symptom of Brachycephalic Obstructive Airway Syndrome (BOAS) and is common in brachycephalic dog breeds and has been reported in brachycephalic cat breeds as well. Some of the other BOAS related symptoms include stenotic nares, everted laryngeal saccules, and laryngeal collapse.

<span class="mw-page-title-main">Intubation granuloma</span> Medical condition

Intubation granuloma is a benign growth of granulation tissue in the larynx or trachea, which arises from tissue trauma due to endotracheal intubation. This medical condition is described as a common late complication of tracheal intubation, specifically caused by irritation to the mucosal tissue of the airway during insertion or removal of the patient's intubation tube.

References

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  2. Padrid, Philip A. (2011). "10 - Laryngoscopy and Tracheobronchoscopy of the Dog and Cat". Small Animal Endoscopy (3rd ed.). Mosby. pp. 331–359. doi:10.1016/B978-0-323-05578-9.10010-5. ISBN   978-0-323-05578-9.
  3. Ruaux, Craig (2011). "34 - The Respiratory System". Small Animal Pediatrics - The First 12 Months of Life. Saunders. pp. 328–339. doi:10.1016/B978-1-4160-4889-3.00034-6. ISBN   978-1-4160-4889-3.
  4. 1 2 Dr Janice Durr Grepe Ph.D (1998). "The Brachycephalic Syndrome (second part)". Healthy Frenchies: An Owner's Manual. ArDesign (95). Retrieved 2010-02-01.
  5. 1 2 3 William E Schultz, DVM (Fall 2007). "Everted Laryngeal Saccules in the Norwich Terrier" (PDF). Norwich & Norfolk News. Norwich & Norfolk Terrier Club. Retrieved 2010-02-01.[ permanent dead link ]
  6. Broyles, Edwin N. (1959-06-01). "XXXIII Anatomical Observations concerning the Laryngeal Appendix". Annals of Otology, Rhinology & Laryngology. 68 (2): 461–470. doi:10.1177/000348945906800213. ISSN   0003-4894. PMID   13661812. S2CID   74862191.
  7. Barnes, David R.; Holinger, Lauren D.; Pellettiere, Edmund V. (1980-03-01). "Prolapse of the Laryngeal Ventricle". Otolaryngology–Head and Neck Surgery. 88 (2): 165–171. doi:10.1177/019459988008800213. ISSN   0194-5998. PMID   7402655. S2CID   26178873.