耳鼻と臨床

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The three dimensional anatomy of the larynx was studied histologically using whole organ sections. The results were summarized as follows: 1. In lateral view, the tip of the vocal process of the arytenoid cartilage is located in the middle of the thyroid ala. 2. Preepiglottic space exists in front of and alongside of the epiglottis. This space has a horse-shoe shape in superior and frontal view. This space nearly extends to the middle of the thyroid ala posteriorly and to the middle of the crista of the thyroid cartilage inferiorly. 3. Elastic cartilage is observed along the upper portion of the arytenoid cartilage from the vocal process to the apex. 4. The posterior glottis is mainly covered with columnar epithelium. A bundle of squamous epithelium extends from the tip of the vocal process to the postero-superior arytenoid region. 5. Laryngeal arteries run in the paraglottic space and cricoid area and do not penetrate intrinsic laryngeal muscles.

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The Effect of the intrinsic laryngeal muscles to the glottis were studied in excised human larynges. The following results were obtained: 1. In the cadaver, the glottis has a waterdrop shape. 2. During vocal fold abduction, the glottis has a pentagonal shape. 3. The ratio of the area of the anterior glottis to that of the posterior glottis is approximately 2 to 3 in both cadaver position and abduction. 4. The thyroarytenoid muscle and the lateral cricoarytenoid muscle are able to close from the anterior commisure to the posterior edge of the ventricle. The glottis does not close from the edge of the ventricle to the posterior wall of the glottis at the level of the vocal fold. 5. The cricothyroid muscle is able to change not only the shape of anterior glottis but also the shape of posterior glottis.

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