Kutta Hannes, Steven Philipp, Paulsen Friedrich
Department of Anatomy, Christian Albrecht University of Kiel, Kiel, Germany.
Cells Tissues Organs. 2006;184(3-4):205-14. doi: 10.1159/000099628.
Due to laryngeal neoplasia, as well as infectious and autoimmune diseases, the subglottic region is of great clinical relevance. However, descriptions of the subglottic structures are inconsistent. The aim of our study was to present a precise analysis of the subglottic region and derive functional and clinical conclusions.
Histological, histochemical and immunohistochemical investigations as well as scanning electron microscopy were performed and combined with injection techniques applied to the subglottic region of the larynges of 33 body donors.
The three-dimensional extensions of the subglottic region were newly defined: the inferior arcuate line of the vocal cord was defined as the cranial border. The lower margin of the cricoid is the caudal border. Craniolaterally, the elastic cone and, further caudally, the cricoid form the border. Therefore, the definition presented comprises heretofore unnamed ventral and dorsal parts of the lower larynx. The subglottic region can be described as cylindrical, becoming smaller in the cranial direction, following the elastic cone. The ventral boundary is formed by the median part of the cricothyroid ligament (ligamentum conicum), the dorsal part by the cricoid cartilage. The walls of the subglottis are divided into three or four layers composed of collagenous and elastic fibres in which seromucous glands are embedded. Subglottic blood vessels including a tight subepithelial capillary plexus were delineated.
The new definition of the subglottic extensions presented is helpful and essential for precise laryngeal tumour classification. The results indicate that the boundaries are unlikely to counteract tumour progression in the subglottis. Furthermore, the findings suggest that these structures contribute to temperature regulation of breath, protection against inflammation as well as breath frequency and depth-dependent mucus secretion.
由于喉肿瘤以及感染性和自身免疫性疾病，声门下区域具有重要的临床意义。然而，对声门下结构的描述并不一致。我们研究的目的是对声门下区域进行精确分析，并得出功能和临床结论。
对33具尸体供体喉部的声门下区域进行组织学、组织化学和免疫组织化学研究以及扫描电子显微镜检查，并结合注射技术。
重新定义了声门下区域的三维范围：声带的下弓形线被定义为头侧边界。环状软骨的下缘为尾侧边界。在头外侧，弹性圆锥以及更靠尾侧的环状软骨形成边界。因此，所提出的定义包括了迄今未命名的下喉的腹侧和背侧部分。声门下区域可描述为圆柱形，沿弹性圆锥在头侧方向逐渐变小。腹侧边界由环甲韧带（圆锥韧带）的中间部分形成，背侧部分由环状软骨形成。声门下壁分为由胶原纤维和弹性纤维组成的三层或四层，其中包埋有浆液性腺。描绘了包括紧密的上皮下毛细血管丛在内的声门下血管。
所提出的声门下范围的新定义有助于精确的喉肿瘤分类且至关重要。结果表明，这些边界不太可能阻碍声门下肿瘤的进展。此外，研究结果表明这些结构有助于呼吸的温度调节、抗炎保护以及与呼吸频率和深度相关的黏液分泌。
