Lateral saccular laryngeal cyst and unexpected asphyxial death

We present the case of a 41-year-old man with a herniated saccular laryngeal cyst in the left cervical region who died unexpectedly at home from acute asphyxia. The laryngeal cyst manifested itself a few days before death under the form of an obvious palpable swelling in the cervical region.The autopsy showed, in the left cervical region, an oval-shaped mass originating on the wall of the larynx and herniated into the extralaryngeal region.The critical reduction of the laryngeal space originated from an intense edema of the laryngeal mucosa above the cysts, concurrent with a flogistic process of the cystic wall, with probable associated glottic laryngospasm mediated by the superior laryngeal nerve. The rapid evolution of edema was favored by the extreme relaxation of the connective of laryngeal mucosa in the supraglottic and aryepiglottic regions, and it explains the sudden death.The case is useful for delineating the problems related to the possible evolution of laryngeal cysts, the pathogenesis of asphyxial complications, the anatomo-pathological diagnosis and the medico-forensic aspects.