Spaces of the Larynx
The larynx contains various spaces, each filled with fat, lymphatic tissue, and blood vessels. These spaces represent potential pathways for tumour spread, which is essential for determining treatment options and understanding disease prognosis.
1. Pre-Epiglottic Space of Boyer: This space is filled primarily with fat, areolar tissue, and lymphatics. Its boundaries help isolate it from other structures while allowing limited communication with adjacent spaces.
Boundaries:
- Anteriorly: Bordered by the thyroid cartilage and the thyrohyoid membrane.
- Superiorly: Enclosed by the hyoepiglottic ligament.
- Posteriorly: Limited by the infrahyoid epiglottis and the quadrangular membrane.
- Laterally: Continuous with the paraglottic space, which allows some level of connectivity between the two.
2. Paraglottic Space: This space is contiguous with the pre-epiglottic space and can act as a pathway for growths that may extend into the neck through the cricothyroid membrane.
Boundaries:
- Laterally: Defined by the thyroid cartilage.
- Inferomedially: Enclosed by the conus elasticus, which provides structural support.
- Medially: Delineated by the laryngeal ventricle and quadrangular membrane.
- Posteriorly: Abutted by the pyriform fossa, which is another space that can influence tumour spread patterns.
3. Reinke’s Space: Situated directly under the epithelial layer of the vocal cords, Reinke’s space is a potential space with minimal connective tissue. It allows for limited movement and flexibility of the vocal cords but is also prone to swelling, known as Reinke’s oedema, which can result in fusiform swelling of the vocal cords.
Boundaries:
- Superiorly and Inferiorly: Contained by the arcuate lines, which define its upper and lower borders.
- Anteriorly: Extends to the anterior commissure of the vocal cords.
- Posteriorly: Reaches the vocal process of the arytenoid cartilage.
Understanding these spaces and their boundaries is critical, especially when addressing potential tumor invasions in the laryngeal area. Each space serves distinct anatomical and functional roles, with implications for surgical approaches and oncological prognosis.
——– End of the chapter ——–
Reference Textbooks.
- Scott-Brown, Textbook of Otorhinolaryngology-Head and Neck Surgery.
- Cummings, Otolaryngology-Head and Neck Surgery.
- Stell and Maran’s, Textbook of Head and Neck Surgery and Oncology.
- Ballenger’s, Otorhinolaryngology Head And Neck Surgery
- Susan Standring, Gray’s Anatomy.
- Frank H. Netter, Atlas of Human Anatomy.
- B.D. Chaurasiya, Human Anatomy.
- P L Dhingra, Textbook of Diseases of Ear, Nose and Throat.
- Hazarika P, Textbook of Ear Nose Throat And Head Neck Surgery Clinical Practical.
- Mohan Bansal, Textbook of Diseases of Ear, Nose and Throat Head and Neck Surgery.
- Hans Behrbohm, Textbook of Ear, Nose, and Throat Diseases With Head and Neck Surgery.
- Logan Turner, Textbook of Diseases of The Nose, Throat and Ear Head And Neck Surgery.
- Arnold, U. Ganzer, Textbook of Otorhinolaryngology, Head and Neck Surgery.
- Ganong’s Review of Medical Physiology.
Author:
Dr. Rahul Bagla
MBBS (MAMC, Delhi) MS ENT (UCMS, Delhi)
Fellow Rhinoplasty & Facial Plastic Surgery.
Renowned Teaching Faculty
Mail: msrahulbagla@gmail.com
India
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