Aryepiglottic fold: Normal topography and clinical implications

Abstract

The aryepiglottic folds extend between the arytenoid cartilage and the lateral margin of the epiglottis on each side and constitute the lateral borders of the laryngeal inlet. They are involved in physiologic closure mechanisms of the larynx and in pathologic conditions such as inspiratory stridor. Information on the normal topography of the aryepiglottic folds is poor and controversial. Therefore, this region was reinvestigated in serial whole‐organ sections of 25 plastinated normal adult human larynges. Dorsally, the right and the left aryepiglottic folds are separated by the interarytenoid notch and comprise the corniculate and cuneiform cartilages, as well as numerous groups of mucous glands. Ventrally, the aryepiglottic folds are adjacent to the peri‐epiglottic adipose tissue. Both regions are clearly separated by several layers of transversely oriented collagenous fiber layers. The muscular constituent of the aryepiglottic folds is only poorly developed, and no muscle fibers insert at the epiglottis. A coherent quadrangular membrane representing a ligamentous “skeleton” of the aryepiglottic folds is absent. A conspicuous collagenous fiber layer is found only to strengthen the free dorsal margin of the fold. Both muscular and ligamentous components may render the aryepiglottic folds sufficiently tense as to resist inspiratory inward suction in normal cases. However, pliability must be preserved to guarantee adequate folding in approximation of the aryepiglottic folds during deglutition. Thereby, the posterior part of the laryngeal inlet is closed, whereas the anterior part is probably closed by independent inward bulging of the peri‐epiglottic adipose tissue. Clin. Anat. 11:223–235, 1998. © 1998 Wiley‐Liss, Inc.

The Quantal Larynx: The Stable Regions of Laryngeal Biomechanics and Implications for Speech Production

“…AE contact is achieved in the simulation (indicated by the dotted contour line and arrows in Figure 11) with a combination of muscle activations similar to VV stop and the addition of, strong thyrohyoid engagement. Aryepiglottic muscles are not represented in QL2, and this simulation demonstrates that such constriction does not require these muscles, mostly consistent with both Fink's (1974a) and Reidenbach's (1997Reidenbach's ( , 1998aReidenbach's ( , 1998b theoretical descriptions of the general closure mechanism (i.e., that anteroposterior laryngeal vestibule closure occurs under thyroid-hyoid approximation, the action of the VT and TE musculature, and the buckling and medializing effects of tissue contacts).…”

“…128-129). The ventricularis (sometimes referred to as the external thyroarytenoid ) muscles were developed with reference to the work of Reidenbach (1997Reidenbach ( , 1998aReidenbach ( , 1998b. Aryepiglottic muscles were omitted on the basis of the lack of clear histological evidence for their existence (Reidenbach, 1998a, p. 233).…”

Anatomical Considerations of the Longitudinal Pharyngeal Muscles in Relation to their Function on the Internal Surface of Pharynx

“…In type IV (31.8 %, 14/44) the muscles inserted into the palatine tonsil, epiglottis, arytenoid cartilage, piriform recess, thyroid cartilage, and pharyngeal wall (Figs. 6,7,8,9).…”

“…The aryepiglottic folds extend between the arytenoid cartilage and the lateral margin of the epiglottis, and comprise the lateral borders of the laryngeal inlet. This fold is associated with physiologic closure mechanisms of the larynx, and is also thought to be a cause of inspiratory stridor [9]. However, the aryepiglottic folds have been described poorly and controversially.…”

Modeling the Biomechanical Influence of Epilaryngeal Stricture on the Vocal Folds: A Low-Dimensional Model of Vocal–Ventricular Fold Coupling

“…Physiological research suggests that a complex combination of internal and external laryngeal mechanisms is responsible for epilarynx constriction (Esling, Zeroual, & Crevier-Buchman, 2007;Fink, 1974;Painter, 1986;Reidenbach, 1998aReidenbach, , 1998bReidenbach, , 1997Sakakibara, Kimura, Imagawa, Niimi, & Tayama, 2004). In constricting, the epilarynx undergoes posteroanterior narrowing, as during swallow or effort closure, causing the soft laryngeal tissues to fold, buckle, and bulge together.…”