The Supraglottic Larynx
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Hello everyone, Sidney Levy here.
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I'm continuing our discussion of the anatomy of
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the larynx, and I would like to concentrate on
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the supraglottis, or the supraglottic larynx.
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I have an example case here of a pre-contrast T1
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weighted set of sequences in three projections.
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There is an incidental postcricoid space mass,
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which we're not going to pay attention to because
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it is not encroaching on the larynx in this case.
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So, focusing on the supraglottis, what is the supraglottis?
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The supraglottis consists of four different areas, being
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the epiglottis, which has a lingual and a laryngeal surface.
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We then have the aryepiglottic folds, but only
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the laryngeal or medial aspect of those folds
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because the lateral aspect belongs to the piriform sinus.
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We also have, a little bit further down, the
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false cords, which are easiest to appreciate
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on the axial or the coronal projection.
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And then adjacent to the false cords, we have
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the paraglottic fat, which is important to be
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able to recognize, as tumor can efface this.
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We also have a preepiglottic space, or preepiglottic
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fat, which also needs to be able to be recognized.
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So what are the boundaries of the supraglottic larynx?
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Superiorly, it is the junction of the base of
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tongue and the lingual surface of the epiglottis.
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So everything beyond this point
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belongs to the supraglottic larynx.
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Above this level, we have the
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base of tongue and the oropharynx.
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At this level, we also have the laryngeal inlet.
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The laryngeal inlet is the line of demarcation
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between the hypopharynx, posteriorly, and the larynx,
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anteriorly, or the supraglottic larynx, in this case.
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So this is all hypopharynx.
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Anteriorly, the wall continues down as far as the
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level of the false cords and the laryngeal ventricles.
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Now, we pointed out the false cords earlier.
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These are the laryngeal ventricles, just underneath,
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and the inferior margin of the supraglottic
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larynx is the superior border of the vocal
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cords at the level of the laryngeal ventricles.
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So that's here.
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Everything below this level is glottis.
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Everything above, up into the level
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of the vallecula, is supraglottis.
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The other structures that you need to be familiar
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with in this region are the laryngeal cartilages.
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Starting at the level of the aryepiglottic
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folds, we come into contact with the
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thyroid cartilage, which I'm outlining here.
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As we move further down to the level of the inferior
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supraglottis, we will start to see the arytenoid cartilages
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and the cricoid cartilage, but they are actually more
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strictly part of the glottis and subglottis, respectively.
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So it's really the thyroid cartilage
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at the level of the supraglottis.
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In our next vignette, we will discuss the
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anatomy of the glottis and its boundaries.
Sidney Levy, PhD, MBBS
Radiologist and Nuclear Medicine Specialist
I-MED
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