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Anatomical bases of glottic widening surgery related to arytenoidectomy.
Clin Anat. 1999; 12(2):94-102.CA

Abstract

Derived from arytenoidectomy, different surgical techniques have been developed for widening the glottis in cases of bilateral vocal cord paralysis. Their anatomical bases were reinvestigated in plastinated serial sections of 25 adult human larynges. At the anterolateral surface of the arytenoid cartilage, blood vessels crossing the crista arcuata may cause bleeding complications. The arytenoid cartilage is related to three major histologic complexes which must be taken into account during surgery. The dense connective tissue complex consists of the cricoarytenoid ligament and the conus elasticus, which are connected ventrocaudally. The cricoarytenoid ligament and the vocal cord are separated by the cartilaginous inscription of the vocal process. The muscular complex consists of the transverse arytenoid muscle, which is the posterior wall of the glottis, and the thyroarytenoid muscle, which is intimately fixed to the conus elasticus near the arytenoid cartilage. The loose connective tissue complex is represented by the vestibular fold, containing adipose tissue, mucous glands, few collagenous fiber septa, and at its posterior end, a small cranial extension of the vocal cord. For glottic widening surgery, the arytenoid cartilage must be regarded as an integrated component of an extended fibro-cartilaginous framework supporting the laryngeal airway. Shrinking processes of the dense connective tissue elements may complicate surgical interventions. Iatrogenic lesions of the posterior glottis should be avoided to prevent the development of synechia or insufficient closure of the larynx during swallowing.

Authors+Show Affiliations

Department of Anatomy, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10089034

Citation

Reidenbach, M M.. "Anatomical Bases of Glottic Widening Surgery Related to Arytenoidectomy." Clinical Anatomy (New York, N.Y.), vol. 12, no. 2, 1999, pp. 94-102.
Reidenbach MM. Anatomical bases of glottic widening surgery related to arytenoidectomy. Clin Anat. 1999;12(2):94-102.
Reidenbach, M. M. (1999). Anatomical bases of glottic widening surgery related to arytenoidectomy. Clinical Anatomy (New York, N.Y.), 12(2), 94-102.
Reidenbach MM. Anatomical Bases of Glottic Widening Surgery Related to Arytenoidectomy. Clin Anat. 1999;12(2):94-102. PubMed PMID: 10089034.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anatomical bases of glottic widening surgery related to arytenoidectomy. A1 - Reidenbach,M M, PY - 1999/3/24/pubmed PY - 2000/6/20/medline PY - 1999/3/24/entrez SP - 94 EP - 102 JF - Clinical anatomy (New York, N.Y.) JO - Clin Anat VL - 12 IS - 2 N2 - Derived from arytenoidectomy, different surgical techniques have been developed for widening the glottis in cases of bilateral vocal cord paralysis. Their anatomical bases were reinvestigated in plastinated serial sections of 25 adult human larynges. At the anterolateral surface of the arytenoid cartilage, blood vessels crossing the crista arcuata may cause bleeding complications. The arytenoid cartilage is related to three major histologic complexes which must be taken into account during surgery. The dense connective tissue complex consists of the cricoarytenoid ligament and the conus elasticus, which are connected ventrocaudally. The cricoarytenoid ligament and the vocal cord are separated by the cartilaginous inscription of the vocal process. The muscular complex consists of the transverse arytenoid muscle, which is the posterior wall of the glottis, and the thyroarytenoid muscle, which is intimately fixed to the conus elasticus near the arytenoid cartilage. The loose connective tissue complex is represented by the vestibular fold, containing adipose tissue, mucous glands, few collagenous fiber septa, and at its posterior end, a small cranial extension of the vocal cord. For glottic widening surgery, the arytenoid cartilage must be regarded as an integrated component of an extended fibro-cartilaginous framework supporting the laryngeal airway. Shrinking processes of the dense connective tissue elements may complicate surgical interventions. Iatrogenic lesions of the posterior glottis should be avoided to prevent the development of synechia or insufficient closure of the larynx during swallowing. SN - 0897-3806 UR - https://www.unboundmedicine.com/medline/citation/10089034/Anatomical_bases_of_glottic_widening_surgery_related_to_arytenoidectomy_ L2 - https://doi.org/10.1002/(SICI)1098-2353(1999)12:2<94::AID-CA3>3.0.CO;2-P DB - PRIME DP - Unbound Medicine ER -