An Anatomic Study of the Suspensory Ligaments of the Anterior Commissure

Abstract

Objectives:

Delineate the location and anterior/posterior and superior/inferior orientation of the suspensory ligaments of the anterior commissure attachment of the vocal folds in order to characterize how much of the laryngeal cartilage may be safely removed for aesthetic or oncologic purposes without compromising vocal function.

Methods:

Study design: anatomic dissection of cadaver larynges. Preserved cadaver larynges were dissected with careful attention to ligamentous attachments to the laryngeal framework of the vocal folds. AP and superior/inferior relationships are described. Removal of various amounts of cartilage around the anterior commissure was correlated with vocal fold length and tension.

Results:

Our results help to characterize the extent to which laryngeal framework may be removed around the anterior commissure while maintaining vocal fold support.

Conclusions:

These data may help surgeons to better understand the degree of laryngeal cartilage that may be safely removed in situations of oncologic resection, aesthetic intervention (eg, aesthetic chondrolaryngoplasty), or post-traumatic reconstruction.