# Endoscopic CO2 Laser Excision of Internal Pyolaryngocele: A Rare Airway Emergency Case Report With Review of the Literature

## TL;DR

This case report describes a rare airway emergency caused by an internal pyolaryngocele and highlights the effectiveness of CO2 laser surgery for its treatment.

## Contribution

The paper presents a novel case of internal pyolaryngocele managed with CO2 laser excision, emphasizing its safety and efficacy.

## Key findings

- CO2 laser microlaryngoscopic excision led to complete healing and no recurrence in the patient.
- Early diagnosis and prompt treatment are critical to prevent life-threatening airway compromise.
- CO2 laser surgery offers a minimally invasive, effective first-line approach for selected internal pyolaryngocele cases.

## Abstract

A pyolaryngocele is a rare, potentially life‐threatening complication of laryngocele, resulting from secondary infection and obstruction of the saccular neck. Clinical severity ranges from mild dysphonia to acute airway compromise. We report a 51‐year‐old man with a sore throat, dysphagia, and dyspnea. Flexible laryngoscopy and contrast‐enhanced CT revealed an internal pyolaryngocele. After emergency tracheostomy and intravenous antibiotics, the patient underwent CO2 laser microlaryngoscopic excision and marsupialization. Postoperative recovery was uneventful, with complete healing and no recurrence at follow‐up. This case underscores the importance of early diagnosis and highlights CO2 laser surgery as an effective, minimally invasive option. Internal pyolaryngocele is a rare airway emergency that requires prompt management. CO2 laser excision appears to be a safe and effective first‐line approach in selected internal cases.

Early recognition of internal pyolaryngocele is crucial to prevent life‐threatening airway compromise. In internal pyolaryngocele, CO2 laser microlaryngoscopic excision offers a safe, effective, and minimally invasive treatment, ensuring rapid recovery, low morbidity, and excellent functional outcomes while minimizing recurrence risk. Prompt diagnosis and tailored surgical management are essential.

Graphical abstract illustrating a large internal pyolaryngocele causing airway narrowing, diagnosed on contrast‐enhanced CT scan.