(A708) Clinical and Etiological Differences in Laryngeal Saccular Cysts: Chronic Laryngeal Posturing and Mucus Entrapment

Introduction: Laryngeal saccular cysts are uncommon lesions impacting both respiratory and vocal function, though some patients may be asymptomatic. This study aims to evaluate the association of lesion laterality and size with symptomatic presentation and other clinical features in patients diagnosed with laryngeal saccular cysts.

Methods: This retrospective cohort study included 35 adult patients diagnosed with laryngeal saccular cysts on laryngoscopy at an academic otolaryngology clinic. All adult patients with confirmed diagnosis of laryngeal saccular cyst on laryngoscopy were eligible for this study. Patient clinical data was abstracted from electronic medical records, and video stroboscopy footage was manually reviewed to confirm lesion characteristics including laterality and size change on vocal fold adduction. Statistical analysis was performed using a chi-squared test and unpaired t-test to determine association between variables.

Results: Lesion laterality was found to be significantly associated with changes in size during stroboscopy (p=0.016), with unilateral—especially right-sided—cysts being more likely to show changes as compared to bilateral. Unpaired t-test revealed BMI averages were significantly higher (p=0.036) in patients with bilateral lesions (mean = 38.39) as compared to unilateral lesions (mean = 28.99).

Conclusions: Lesion laterality, size, and BMI may influence the clinical presentation of laryngeal saccular cysts. Larger, bilateral cysts show changes on stroboscopy, and patients with higher BMI tend to present with bilateral lesions. This suggests that lesions with these findings, along with BMI, could inform diagnostic and management strategies in laryngeal saccular cyst cases.