Barriers and Spaces of the Larynx see Figure

• Quadrangular Membrane: fibroelastic membrane, supports supraglottis, extends from epiglottis to arytenoid and corniculate cartilage

• Conus Elasticus: fibroelastic membrane, supports vocal fold, extends from cricoid cartilage to merge with vocal ligament (resists spread of glottic and subglottic cancers)

• Pre-epiglottic Space: midline fibrofatty-filled space bounded by the hyoid bone, thyrohyoid membrane, hyoepiglottic ligament, thyroepiglottic ligament, and epiglottis; tumor may enter from anterior commissure or supraglottic extension; continuous with paraglottic space

• Paraglottic Space: fibrofatty-filled space outside of conus elasticus and quadrangular membrane; allows transglottic extension

• Reinke's Space: superficial lamina propria of true vocal fold, lack of lymphatics and blood vessels permits rapid tumor extension

Supraglottis

Glottis _L

Subglottis 1

Supraglottis

Figure 5—1. Coronal section of the larynx demonstrating the barriers and divisions of the larynx

Hyoid bone

Quadrangular membrane

Thyroid cartilage

Paraglottic space

Thyroarytenoid muscle

Conus elasticus

Cricoid cartilage

Figure 5—1. Coronal section of the larynx demonstrating the barriers and divisions of the larynx

• Broyles' Tendon: insertion of vocalis tendon to thyroid cartilage; allows tumor spread into thyroid cartilage (no perichondrium found at insertion site)

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