Bignardi L
Arch Otorhinolaryngol. 1977 Jul 29;217(2):167-73. doi: 10.1007/BF00665535.
The histological structure of the supraglottic submucosa consists of a wide-mesh connective net, which builds compartments where glands are included. Somewhere, the walls of compartments are so thick that they may be considered as true ligaments. Some of them are located at the limit between glottis and supraglottis; therefore one may argue that the so-called "biological vallum", which hinders the downward propagation of supraglottic cancers is not only due to the interruption of lymph ways between vestibulum and vocal chords but also to the presence of this thick connective barrier. Two gaps interrupt the continuity of the barrier, the first one at the anterior commissure, the second at the posterior extremity of the ventricle. The situation of the gaps corresponds to the main directions of propagation of the supraglottic cancers, when they spread inferiorly.
声门上黏膜下层的组织结构由一个宽网孔结缔组织网组成,该结缔组织网形成了包含腺体的隔室。在某些部位,隔室壁非常厚,以至于可被视为真正的韧带。其中一些位于声门和声门上之间的界限处;因此,可以认为所谓的“生物堤”,它阻碍了声门上癌的向下扩散,不仅是由于前庭和声带之间淋巴通路的中断,还由于这种厚结缔组织屏障的存在。两个间隙中断了屏障的连续性,第一个在前连合处,第二个在心室的后端。这些间隙的位置与声门上癌向下扩散时的主要扩散方向相对应。