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  • 1
    Electronic Resource
    Electronic Resource
    New York, NY [u.a.] : Wiley-Blackwell
    Clinical Anatomy 8 (1995), S. 327-333 
    ISSN: 0897-3806
    Keywords: cartilage ; joint ; larynx ; nerve compression ; posterior cricoarytenoid muscle ; Life and Medical Sciences ; Miscellaneous Medical
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: The posterior cricothyroid ligament and its topographic relation to the inferior laryngeal nerve were studied in 54 human adult male and female larynges. Fourteen specimens were impregnated with curable polymers and cut into 600-800 μm sections along different planes. Forty formalin-fixed hemi-larynges were dissected and various measurements were made. The posterior cricothyroid ligament provides a dorsal strengthening for the joint capsule of the cricothyroid joint. Its fibers spread in a fan-like manner from a small area of origin at the cricoid cartilage to a more extended area of attachment at the inferior thyroid cornu. The ligament consists of one (7.5%) to four (12.5%), in most cases of three (45.0%) or two (35.0%), individual parts oriented from mediocranial to latero-caudal. The inferior laryngeal nerve courses immediately dorsal to the ligament. In 60% it is covered by fibers of the posterior cricoarytenoid muscle, in the remaining 40% it is not. In this latter topographic situation there is almost no soft tissue interposed between the nerve and the hypopharynx. Therefore, the nerve may be exposed to pressure forces exerted from dorsally. It may be pushed against the unyielding posterior cricothyroid ligament and suffer functional or structural impairment. Probably, this mechanism may explain some of the laryngeal nerve lesions described in the literature after insertion of gastric tubes. © 1995 WiIey-Liss, Inc.
    Additional Material: 3 Ill.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    New York, NY [u.a.] : Wiley-Blackwell
    Clinical Anatomy 8 (1995), S. 273-280 
    ISSN: 0897-3806
    Keywords: cricoid cartilage ; endotracheal intubation ; stenotic lesion ; subglottic region ; Life and Medical Sciences ; Miscellaneous Medical
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: The subglottic regions of 54 human adult male and female larynges were studied with regard to anatomical aspects of postintubational stenosis. Fourteen specimens were impregnated with curable polymers and cut into 600-800 μm sections along different planes. Forty formalin-fixed hemilarynges were dissected. Measurements of the upper cricoid lamina and the thickness of the endocricoid soft tissues were taken for statistical analysis. Immediately beneath the glottis, the upper part of the cricoid lamina consists of two lateral plates with an average angle of 110°. Distally, the cricoid adopts a more and more rounded lumen. At the level of the cricothyroid joint, the definite airway lumen is always laterally narrowed by a prominent thickening of the endocricoid soft tissue. Large amounts of loose connective tissue facilitate the development of edema in case of injury in this region. Dorsally, the submucous stratum is smaller and consists mainly of dense connective tissue. The blood vessels are fixed to the cricoid perichondrium by collagenous fibers. Any pressure applied from the airway lumen will force the vessels against the nonresilient cartilage, resulting in occlusion and ischemia. These pathophysiologic mechanisms are important for the development of early laryngeal damage during endotracheal intubation, possibly resulting in posterior stenosis due to scarring later on. © 1995 WiIey-Liss, Inc.
    Additional Material: 3 Ill.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    New York, NY [u.a.] : Wiley-Blackwell
    Clinical Anatomy 7 (1994), S. 324-330 
    ISSN: 0897-3806
    Keywords: cricoarytenoid joint ; articulating surface ; ligament ; muscle ; endotracheal intubation ; Life and Medical Sciences ; Miscellaneous Medical
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: The cricoarytenoid joints of 12 human adult male and female larynges were studied with regard to the anatomical reasons for arytenoid cartilage dislocation. The specimens were impregnated with curable polymers as a whole and then cut into 600-800 μm sections along different planes. The articulating surface at the upper border of the cricoid lamina revealed a striking extension backward and occasionally even slightly distalward. This may allow the arytenoid cartilage to glide in a posterior direction until it partially looses its contact to the cricoid facet. In physiologic conditions, the arytenoid position is balanced along a sagittal plane between the posterior cricoarytenoid ligament dorsally and the thyroarytenoid muscle ventrally. If one of these structures is damaged, i.e., by medical disease or trauma, the arytenoid cartilage may be pushed easily in the opposite direction. Arytenoid dislocation mainly in a posterior direction is described in literature as a possible complication of endotracheal intubation. Preparatory pharmacological muscle relaxation leads to paralysis of the thyroarytenoid muscle and its ventrally directed traction on the arytenoid cartilage. As the shape of the articulating surfaces, especially the peculiarities of the cricoid facet, even facilitates a dorsally directed movement of the Arytenoid cartilage, it may be easily displaced in a posterior direction during the procedure of endotracheal intubation. © 1994 Wiley-Liss, Inc.
    Additional Material: 6 Ill.
    Type of Medium: Electronic Resource
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