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Larynx

Synonym: voice box
German: Larynx, Kehlkopf

1 Definition

The larynx is a closing apparatus formed by cartilages, muscles and fibers that is separating the trachea from the esophagus.

2 Anatomy

2.1 Topography

You can divide the larynx into three levels:

  • The Supraglottis, also called Vestibulum laryngis, is the upper level. It reaches from the larynx entrance (Aditus laryngis) to the gap between the vestibular folds (Plicae vestibulares).
  • The glottis, or Cavitas laryngis intermedia, forms the middle level. It reaches from the Rima vestibuli to the actual glottic opening (Rima glottidis).
  • The subglottis, or Cavitas infraglottica, is the lower level. It forms the space caudal to the glottic opening, and transitions into the trachea on the inferior border of the cricoid cartilage.

2.2 Cartilagineous frame

The form of the larynx is determined by a cartilagineous frame, which consists of 4 elements:

This cartilagineous frame is suspended in cranial direction on the Os hyoideum (hyoid bone). Additionally, there are 3 small, paired cartilages which, however, do not influence the form of the larynx:

2.3 Larynx articulations

The cartilagineous elements of the larynx articulate with each other via two articulations:

2.3.1 Articulatio cricothyroidea

The Articulatio cricothyroidea is a hinge joint that serves the regulation of the lenght and tension of the vocal cords. It has the following articular surfaces:

  • Cornu inferius of the Cartilago thyroidea
  • Posterior side of the Cartilago cricoidea

2.3.2 Articulatio cricoarytaenoidea

The Articulatio cricoarytaenoidea is a turn-slide-hinge joint that influences the width of the vocal cords and makes an important contribution to phonation. Its articular surfaces are:

  • Articular cavity of the Cartilago arytaenoidea
  • prominent Facies articularis of the Cartilago cricoidea

2.4 Larynx muscles

There are muscle groups that influence the vocal cords or the opening of the glottic opening, respectively, strained between the cartilages The larynx muscles comprise amongst others:

2.5 Innervation

The larynx is innervated motorically and sensitively via the branches of the Vagus nerve, more exactly via the superior laryngeal nerve and the recurrent laryngeal nerve.

The superior laryngeal nerve innervates just the exterior larynx muscle (Musculus cricothyroideus), the recurrent laryngeal nerve all of the interior larynx muscles. For the sensitive nerve supply, the glottic opening serves as demarcation line: above the glottic opening, the superior laryngeal nerve provides supply; below, itís the inferior laryngeal nerve.

3 Physiology

The larynx completes a spectrum of highly various tasks:

During deglutition, the glottic opening and the epiglottis are closed. This prevents the chyme to get from the oral cavity or pharynx into the lower airways.

4 Clinical presentation

The pathological changes in the area of the larynx are the domain of ENT medicine. The most important disease patterns comprise amongst others:

5 Treatment methods

Microsurgery of the larynx

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