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Anatomy of Neck and Blood Supply of Brain
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
The major bones of the neck include the cervical vertebrae and hyoid bone. Laryngeal cartilages consist of thyroid, cricoid, epiglottis, arytenoid, corniculate and cuneiform. They also form an important part of the support system of the neck.
Common paediatric ENT viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Benjamin Hartley, Richard J Hewitt
The aetiology is poorly understood; two common theories are the neurologic and cartilaginous theories. In the neurologic theory, there is sensorineuromotor dysfunction, reduced neuromuscular tone and laryngeal coordination. Gastroesophageal reflux may contribute to mucosal oedema and reduced laryngeal sensation. Increased work of breathing may in turn exacerbate reflux owing to negative intrathoracic pressure. In the cartilaginous theory, immature laryngeal cartilage offers insufficient mechanical resistance to collapse, causing collapse of the supraglottic structures on inspiration. The resulting mucosal trauma causes oedema, further worsening the stridor. This theory has not been supported by histopathology or the lack of laryngomalacia in premature babies and at birth. The commonest theory is now that laryngomalacia is a normal anatomical variant which is predisposed to collapse on inspiration until such time as the airway grows and the tissues mature.
Anatomy of the Larynx and Tracheobronchial Tree
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The extrinsic ligaments of the larynx connect the laryngeal cartilages to the hyoid above and trachea below (see Figure 58.4). Superiorly, the thyrohyoid membrane stretches between the upper border of the thyroid cartilage and the posterior surface of the body and greater cornua of the hyoid. The membrane is composed of fibroelastic tissue, reinforced by fibrous tissue in the midline as the median thyrohyoid ligament and posteriorly as the lateral thyrohyoid ligament. The latter connects the tip of the superior cornua of the thyroid cartilage to the posterior ends of the greater cornua of the hyoid. The ligaments often contain a small nodule of cartilage, the cartilago triticea. The membrane is pierced by the internal branch of the superior laryngeal nerve and by the superior laryngeal vessels. The cricotracheal ligament unites the lower border of the cricoid with the first tracheal ring.
Mobility of the arytenoid cartilage in glottic carcinoma: a CT image study
Published in Acta Oto-Laryngologica, 2023
Li Wang, Xi Zeng, Kai Li, Yunxin Lu, Dongxiao Nong
Fibreoptic laryngoscopy provides excellent views of mucosal waves, mucosal lesions, and VC/AC mobilities. It offers undoubtful advantages for clinical evaluation and staging of laryngeal carcinoma and helps to develop a tailored therapeutic plan. Nevertheless, laryngoscope enables only subjective assessment. The 3D structure of the laryngeal cartilage is complex, many structures are deeply embedded in soft tissues and are not visible or measurable through a laryngoscope, making qualitative descriptions and quantitative measurements impossible. Difficulties in assessment also arise when a large laryngeal tumour partially or even completely obscured the glottis. Compared to laryngoscopy, CT scan is weak in early mucosal changes and continuous images, yet has an outstanding performance in presenting various laryngeal structures including cartilages and cords.
The effect of nasal septum deviation on voice aging
Published in Logopedics Phoniatrics Vocology, 2022
Ceren Ersoz Unlu, Ozlem Akkoca
The voice often reflects a person’s age. We can often guess the approximate age of people when their voice is heard even if we do not see them. While the most prominent change in voice occurs during childhood, deterioration in the quality of voice is typically observed after the age of 50 years. The deterioration of the voice is the result of anatomical and histological changes in the larynx. Displacement of the larynx to a lower position in the neck with increasing age affects the resonance of the voice. Ossification of laryngeal cartilages decreases the elasticity of the larynx. Vocal fold bowing due to the aging process is responsible for increased breathiness and reduced volume of the voice, which is largely attributable to vocal muscle atrophy [1]. Changes in the structure of the lamina propria such as increase in collagen fibers (especially mature type I fibers) and elastin (but elasticity properties diminish) and a decrease in hyaluronic acid affect the vibratory properties of the vocal folds [2,3]. Decrease in epithelial thickness and salivary gland function also have an effect on the aging voice. However, voice changes associated with aging are often masked by submucosal edema in women and voice characteristics of aging differ in both genders [1].
Clinical outcome and comparison between squamous and non-squamous cell carcinoma of the larynx
Published in Acta Oto-Laryngologica, 2020
Le Chen, Weiye Deng, Cai Li, Huiching Lau, Lei Tao, Shuyi Wang, Liang Zhou, Ming Zhang
Chondrosarcoma is the most common type of sarcoma occurring in the larynx, although it reportedly only accounts for ∼0.2% of all laryngeal malignancies [18]. The cricoid cartilage represents the most frequent laryngeal cartilage harboring this tumor (72–75%), followed by the thyroid and arytenoid cartilages and the epiglottis [19]. Chondrosarcoma presents as a submucosal lesion with an intact overlying mucosa on laryngoscopy, and a variably dense, expansile lesion with characteristic calcification is usually seen on imaging examinations, particularly on computed tomography (CT) or magnetic resonance imaging (MRI). The majority of chondrosarcomas of the larynx are low-grade histologically, and grade 1 chondrosarcomas are composed of bi- or multinucleated chondrocytes and include areas of calcification, but characteristically lack mitotic activity (Supplemental Figure 11). Due to the frequent occurrence of laryngeal chondrosarcoma on the cricoid cartilage, specifically the posterior lamina, total laryngectomy is the main treatment approach, whereas the role of radiotherapy is controversial. The OS outcome for this malignancy is favorable and significantly better than that for other laryngeal malignancies [19].