The Cricothyroid Space: Topography and Clinical Implications

Abstract

The inferior border of the thyroid cartilage and the superior rim of the cricoid arch are connected by the cricothyroid membrane and partly covered by the cricothyroid muscles ventrally. This region has been termed the cricothyroid space (CS) and is important with regard to surgical procedures, the spread of laryngeal cancer and traumatic lesions of the larynx. The precise topographic relations of the CS were investigated in plastinated serial sections of 21 normal adult human specimens. The CS consists of a caudal and a cranial portion, which are different with regard to their cartilaginous framework and their relationship to intralaryngeal structures. The caudal portion is bordered by the cricoid cartilage and reveals a complete separation of extra- and intralaryngeal regions by the cricothyroid membrane. It provides an easy access to the subglottic airways. The cranial portion of the CS is mainly bordered by the thyroid cartilage. It is characterized by a gap lateral to the median cricothyroid ligament. This allows a connection of extra- and intralaryngeal adipose tissue. There, extralaryngeal extension of laryngeal cancer preferentially occurs. Traumatic subglottic ruptures of the larynx involve both the caudal and cranial portions of the CS, which often results in extensive scar tissue formation.

Relationship of the Cricothyroid Space with Vocal Range in Female Singers

“…The cricothyroid ligament is the thickened vertical middle segment of the cricothyroid membrane. The band is narrower at the top where it is attached to the thyroid cartilage, and broadens as it descends to attach to the cricoid cartilage (Reidenbach, 1996). of these surgeries).…”

“…of these surgeries). Cadaver studies have been performed to define the best surgical approach to minimize tissue damage (Reidenbach, 1996) and to study the anatomy of the CT space with specific reference to structures within 1cm of the midline (Goumas, et al, 1997).…”

“…The majority of studies to investigate the anatomy and function of the CT space have been carried out in human cadavers Reidenbach, 1996;Goumas, et al, 1997). This has been accepted as a legitimate way to study human larynges (Van Den Berg & Tan, 1959) ; used with permission from Elsevier)…”

Intrinsic and extrinsic forces determine the distortion of the split cricoid ring

“…The mid-ventral cricothyroid ligament is running from the upper rim of the cricoid cartilage to the lower rim of the thyroid cartilage [7]. The soft tissue lining of the subglottic lumen (conus elasticus/cricovocal membrane) includes a layer of elastic fibers (tunica elastica), which supports the mucosa and is suspended to the cricoid.…”