Prolapse of the laryngeal ventricle.

Many varied lesions may protrude into the laryngeal lumen from between the true and false vocal cords. These protrusions can be precisely diagnosed only by biopsy. Prolapse of the laryngeal ventricle is one of these lesions; it is a distinct clinicopathologic entity, a primary lesion unrelated to other laryngeal or systemic disease. Eversion of the ventricle (or saccule) is a similar protrusion that is secondary to pulsion or traction by an associated laryngeal lesion. Other lesions that may produce similar clinical findings and gross appearance include benign tumors, cysts, and, rarely, squamous cell carcinoma. Biopsy is therefore mandatory to plan rational treatment. A review of 26 patients who had been diagnosed as having prolapse resulted in the reclassification of 20 cases of prolapse and six cases of eversion. Prolapse is possibly unrelated etiologically to cough, or chronic laryngeal or respiratory tract infection. The histopathologic data suggest further that prolapse is a result of fatty infiltration, edema, and inflammation of the periventricular tissue above the ventricle, which cause the tissue to enlarge and protrude into the laryngeal lumen from between the true and false vocal cords.