Functional and clinical anatomy of the posterior insertion of the human vocal ligament

European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
F Paulsen, Bernhard N Tillmann

Abstract

The suggested methods of the formation of intubation granuloma as well as carcinoma invasion in the area of posterior vocal ligament insertion have been controversial. One reason for divergent opinions is possibly based on different judgements of morphology in this region. The present study analyzed structures of the vocal ligament and vocalis muscle insertion at the vocal process by means of histological, immunohistochemical and electron microscopic methods. Investigations were performed in three planes on the vocal cords of 22 men and 19 women (aged 21-97 years). Inside the insertion zone of the vocal ligament at the vocal process three structures could be distinguished: hyaline cartilage at the base of arytenoid cartilage, elastic cartilage at its apex and the posterior elastic nodule in front of them. No perichondrium could be seen around the elastic nodule. In elastic nodules type I and type III collagen fibrils as well as elastic fibers formed a scissor-like meshwork around large fibroblasts. The vocalis muscle inserted at the perichondrium in the lateral part of the arytenoid skeleton by short tendons. At the insertion zone blood vessels of the vocalis muscle penetrated the perichondrium and reached the cartilaginous mat...Continue Reading

References

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Citations

Mar 4, 2000·Journal of Anatomy·F PaulsenB Tillmann
Mar 25, 2009·The Laryngoscope·Jacob ShveroTuvia Hadar
Jun 1, 2010·The Laryngoscope·Andreas AnagiotosJuergen Koebke
Feb 6, 2014·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Horst ClaassenFriedrich Paulsen
Jun 21, 2005·Journal of Voice : Official Journal of the Voice Foundation·Adam D RubinRobert T Sataloff

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