Laryngocoele.

All cases of laryngocoele in the English literature have been reviewed and a further nine added, making a total of 139. The sex incidence is 5:I in favour of men, and the maximum age incidence is in the sixth decade. Approximately two out of three laryngocoeles are unilateral and they may be combined, external or internal, with roughly equal frequency; about 8 per cent become infected and present as pyocoele. The commonest presenting symptoms are hoarseness and a lump in the neck, with almost equal frequency. There is only one case on record where the laryngocoele could have been caused by prolonged and repeated blowing against resistance. This factor appears to play no part in the cause of laryngocoele though increased air pressure in the larynx may make an already existing laryngocoele manifest; this increased air pressure may be caused by a co-existing carcinoma. Laryngocoeles appear to be an atavistic remnant from the higher apes, particularly those who use their arms with the thoracic cage fixed whilst swinging through the trees.