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Bilateral Saccular Cysts after Cocaine Use

Saccular lesions are rare anomalies of the larynx that can present as internal, external, or combined cystic masses. Although the exact cause is unknown, it is speculated that a sudden increase in intraglottic pressure combined with a congenital anomaly of the larynx predisposes to its formation. Diagnosis rests on maintaining a high index of clinical suspicion and performing a thorough laryngeal examination, which may be supplemented by obtaining either CT or MRI. We present an unusual case of bilateral, combined internal and external saccular cysts resulting in acute upper airway obstruction after an episode of cocaine inhalation. After emergent tracheotomy, elective repair was undertaken with complete excision of both saccular cysts without complications. We present our case and review the relevant literature regarding two particular saccular lesions, namely, saccular cysts and laryngoceles.