The Anterior Commissure Revisited

Abstract

Reexamination of the anterior commissure from the perspective of semantics, the anatomy of tumor spread, and connective tissue histology and embryology has reaffirmed previously published findings. In addition, this investigation of the convergence of the various structures toward the anterior commissure has led to the hypothesis that the anterior subglottic larynx may have a midline embryological origin. Whether this area should be included in the “anterior commissure” or possibly better considered as an area to which anterior commissure tumors spread is as yet undetermined.

Modified subtotal laryngectomy with cricohyoidoepiglottopexy?long term results in 81 patients

“…For T2 glottic carcinomas, the local failure rate with radiotherapy alone is 27%, necessitating salvage by partial or total laryngectomy. 7 Involvement of the anterior commissure might be the cause of these local recurrences because several authors stress that the spread of small glottic cancers from the anterior commissure to the thyroid cartilage can be underdiagnosed, [8][9][10] and other studies have shown rates of recurrence for T2 carcinomas involving the anterior commissure after primary radiotherapy of 40%. 5 Moreover, technical difficulties hinder radiotherapy when the anterior commissure is involved.…”

Carcinoma of the Anterior Commissure of the Larynx: II. Proposal of a New Staging System

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The absence of a universally accepted anatomic and clinical definition of the AC region and the lack of consideration of AC involvement in the principal T stages by the current T classifications of glottic cancer (AJC,21 UICC22) add much to the problem. Since a careful analysis of the human larynx during development allowed us to identify the AC subsite with better detail than previously known, as shown in part I of this paper, 23 we have tried to transfer the results of that study to clinical medicine, as follows.…”

“…A total dose in the range of 5,600 to 6,700 cGy was delivered in fractions of 200 cGy, 5 days a week. Radiotherapy was employed 1) in patients with small AC lesions involving both vocal cords, 2) in older patients, 3) in patients with unsatisfactory general conditions, and 4) in patients who refused surgery.…”

Posterior Commissure of the Human Larynx Revisited

“…[8][9][10][11] The Tucker Collection has also been studied by G. Tucker Jr and J. Tucker, and multiple publication references are noted. 2 …”