Borders and topographic relationships of the paraglottic space

Abstract

The precise topographic relationships of the paraglottic space (PGS) were investigated in serial plastinated or frozen whole-organ sections of 46 normal adult larynges. Laterally, the PGS was bordered by the thyroid cartilage. Superomedially, the PGS in some specimens was only separated from the periepiglottic space by a coherent collagenous fiber septum. The paraglottic adipose tissue extended between the caudal fibers of the thyroarytenoid muscle. Inferomedially, the PGS was bordered by the conus elasticus. The anteroinferior portion of the PGS extended beyond the larynx beneath the inferior rim of the thyroid cartilage. Posteroinferiorly, the paraglottic adipose tissue extended towards the cricoarytenoid joint. Dorsally, the PGS was bordered by the mucosal lining of the piriform sinus. Due to the intimate topographic and histologic relationships present, cancer involving the PGS may rapidly infiltrate all adjacent anatomic structures.

Magnetic resonance for laryngeal cancer

“…In fact, this space is not simply a fat tissue stripe deep to the vocal cords. It is a complex volume filled with adipose and loose connective tissue [9,10]. Laterally, the space is confined by the thyroid cartilage, medially by the quadrangular lamina and the ventricle, inferiorly by the conus elasticus, and posteriorly by the piriform sinus.…”

Relationship between paraglottic space invasion and cervical lymph node metastasis in patients undergoing supracricoid partial laryngectomy

“…Posteroinferiorly, the paraglottic adipose tissue extends towards the cricoarytenoid joint, and dorsally, the PGS is bordered by the mucosal lining of the piriform sinus. The PGS contains the descending branch of the superior thyroid artery 11, 12. Furthermore, cervical lymph node metastasis readily occurs in patients with extension of supraglottic cancer into the paraglottic space 12…”

Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European Laryngological Society

“…T3 tumors of the laryngeal surface of the infrahyoid epiglottis growing into the open-neck central portion of the pre-epiglottic space are suitable for a supraglottic partial resection only when it can guarantee a full resection of the pre-epiglottic space. Indeed, studies of Kirchner and Carter [13], Sato et al [27] and Reidenbach [20,21] demonstrated the presence of Wbroelastic membranes that limit the central pre-epiglottic space and pose resistance to tumor growth. Additionally, tumors growing through the foramina of the epiglottic cartilage are enclosed by some sort of pseudocapsule [12].…”