Morphological study of the laryngeal anterior commissure with regard to the spread of cancer.

This morphological study, done on larynges from male cadavers from 40 to 60 years of age, sectioned horizontally and dye-stained, shows that in the anterior commissure, at the level of the upper surface of the vocal cords, there is a structure which could be of cancerological interest, termed the X-space by the authors. This structure, 1.5-2.0 mm long, is composed of a homogeneous layer of dense fibrous connective tissue located between the dihedral angle of the thyroid cartilage and the laryngeal mucosa. Vascular and glandular formations penetrate the segments above and below this point, making the connective layer less homogeneous. As the X-space is a point of greater resistance to the deep spread of the tumor, the dissemination of cancer at this level is more likely to occur along the mucosa: this allows the surgeon to ascertain the exact margins of the tumor.