Three-dimensional analysis of cricoarytenoid joint motion. 1998

R C Wang
Division of Otolaryngology-Head and Neck Surgery, University of Nevada School of Medicine, Las Vegas 89102, USA.

The normal motion of the cricoarytenoid joint was characterized and analyzed in this study using seven fresh cadaver larynges mounted rigidly in an external fixator apparatus after radiopaque markers were attached to laryngeal landmarks. Fluoroscopic imaging and recording was performed of top, front, and side views while the arytenoid cartilages of each larynx were manipulated through the full range of motion from adduction to abduction. Computer video capture was performed of the recordings and editing of still frames accomplished to generate three-dimensional plots of cricoarytenoid joint motion, which are shown in the manuscript. Selective and varying sequential disconnection of muscular and ligamentous structures to the arytenoid cartilage was achieved to determine their contributions to cricoarytenoid joint motion limitations and stability. The vocalis ligament, cricoarytenoid ligament, and conus elasticus are most important in controlling abduction, whereas the posterior cricoarytenoid muscle and conus elasticus are crucial in limiting adduction. The vocalis ligament prevents posterior displacement of the vocal process, while the cricoarytenoid ligament and a newly described ligament, the posterior capsular ligament, restricts anterior vocal process migration. Another ligament, the anterior capsular ligament, is described, which limits backward arytenoid cartilage tilting and lateral movement of the arytenoid cartilage on the cricoid cartilage facet. Section of the vocalis ligament with underlying conus elasticus produced reducible lateral arytenoid cartilage subluxation. Confirmation of cricoarytenoid joint facet relationships in full adduction and abduction was accomplished by fixation of the cricoarytenoid joints of one larynx in the two positions with adhesive, and subsequent exposure of the joint surfaces. Review of literature detailing human laryngeal embryological development shows that the glottis and arytenoid cartilages are formed in adduction, which explains how cricoarytenoid joint ligaments collaborate to achieve accurate vocal process approximation in adduction despite side-to-side asymmetries of the cricoarytenoid joint structures in the same larynges.

UI MeSH Term Description Entries
D007596 Joints Also known as articulations, these are points of connection between the ends of certain separate bones, or where the borders of other bones are juxtaposed. Joint
D007830 Larynx A tubular organ of VOICE production. It is located in the anterior neck, superior to the TRACHEA and inferior to the tongue and HYOID BONE. Anterior Commissure, Laryngeal,Anterior Commissure, Larynx,Laryngeal Anterior Commissure,Laryngeal Posterior Commissure,Posterior Commissure, Laryngeal,Posterior Commissure, Larynx,Anterior Commissures, Laryngeal,Anterior Commissures, Larynx,Commissure, Laryngeal Anterior,Commissure, Laryngeal Posterior,Commissure, Larynx Anterior,Commissure, Larynx Posterior,Commissures, Laryngeal Anterior,Commissures, Laryngeal Posterior,Commissures, Larynx Anterior,Commissures, Larynx Posterior,Laryngeal Anterior Commissures,Laryngeal Posterior Commissures,Larynx Anterior Commissure,Larynx Anterior Commissures,Larynx Posterior Commissure,Larynx Posterior Commissures,Posterior Commissures, Laryngeal,Posterior Commissures, Larynx
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009068 Movement The act, process, or result of passing from one place or position to another. It differs from LOCOMOTION in that locomotion is restricted to the passing of the whole body from one place to another, while movement encompasses both locomotion but also a change of the position of the whole body or any of its parts. Movement may be used with reference to humans, vertebrate and invertebrate animals, and microorganisms. Differentiate also from MOTOR ACTIVITY, movement associated with behavior. Movements
D003413 Cricoid Cartilage The small thick cartilage that forms the lower and posterior parts of the laryngeal wall. Cartilage, Cricoid,Cartilages, Cricoid,Cricoid Cartilages
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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