Reidenbach M M
Department of Anatomy, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany.
Clin Anat. 1996;9(4):244-51. doi: 10.1002/(SICI)1098-2353(1996)9:4<244::AID-CA5>3.0.CO;2-E.
Transglottic cancer of the larynx crosses the laryngeal ventricle and involves both the vestibular and vocal folds. It has been described to spread within the paraglottic space (PGS). This region of adipose tissue, containing blood vessels and nerves, immediately adjacent to the thyroid laminae, was originally defined by Tucker and Smith (1962). However, the precise topographic relationships of this clinically important space are still controversely discussed. Therefore, a reinvestigation was done in serial sections of 19 plastinated adult human larynges. Laterally, the PGS is bordered by the thyroid cartilage. Superomedially, the PGS is continuous with the preepiglottic space (PES) in most specimens. In some cases, the PGS and the PES are completely separated from each other by a conspicuous collagenous fiber septum. Small projections of the paraglottic adipose tissue extend between the fibers of the thyroarytenoid muscle. Inferomedially, the PGS is bordered by the conus elasticus. Anteroinferior extensions of the PGS escape the larynx beneath the inferior rim of the thyroid cartilage. Posteroinferiorly, the paraglottic adipose tissue extends between the intrinsic laryngeal muscles and towards the cricoarytenoid joint. Dorsally, the PGS is bordered by the mucosal lining of the piriform sinus. A precise knowledge of the topography of the PGS can explain typical symptoms and routes of spread of tumorous growth: extension toward the hypopharynx, extension into the anterior extralaryngeal tissues, invasion of the thyroid cartilage, impairment of vocal cord movements due to infiltration of laryngeal muscles or immobilization of the cricoarytenoid joint.
喉声门跨区癌穿过喉室，累及前庭襞和声襞。已有文献报道其在声门旁间隙（PGS）内扩散。这个紧邻甲状软骨板、含有血管和神经的脂肪组织区域最初由塔克和史密斯在1962年定义。然而，这个临床重要间隙的确切解剖关系仍存在争议。因此，我们对19个经塑化处理的成人喉部连续切片进行了重新研究。在侧面，PGS以甲状软骨为界。在大多数标本中，PGS在超级内侧与会厌前间隙（PES）相连。在某些情况下，PGS和PES被一条明显的胶原纤维隔膜完全分隔开。声门旁脂肪组织的小突起在甲杓肌纤维之间延伸。在下方内侧，PGS以弹性圆锥为界。PGS的前下延伸部分在甲状软骨下缘下方穿出喉部。在后方下方，声门旁脂肪组织在喉内肌之间延伸并朝向环杓关节。在背侧，PGS以梨状窦的黏膜为界。对PGS解剖结构的精确了解可以解释肿瘤生长的典型症状和扩散途径：向下咽延伸、延伸至喉外前组织、侵犯甲状软骨、因喉肌浸润或环杓关节固定导致声带运动障碍。
