A 28-year-old trumpet player underwent multiple treatments with radioactive iodine for Graves disease associated with an unusually large goiter. Following his second treatment, the patient developed acute neck pain and swelling. Radiographic studies and a laryngoscopy demonstrated bilateral symptomatic external laryngoceles, a very rare entity, not previously known to be associated with radioiodine treatment or Graves disease. The patient's profession placed him at risk for the development of a laryngocele, but the temporal relationship to goiter regression following radioiodine therapy suggests that this occurred as a result of this treatment. The patient's disease was managed nonsurgically, and he has subsequently done well. This represents the first known association of symptomatic laryngocele with radioiodine treatment for Graves disease.
External view of patient's neck while playing trumpet, demonstrating external laryngocele.
Frontal plain radiograph of the neck showing bilateral air-filled laryngoceles during Valsalva maneuver.
Lateral plain film of the neck demonstrating air-filled laryngocele during Valsalva and following barium swallow (no contrast medium).
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