Topographical anatomy and oncologic implications of the anterolateral surface of the arytenoid cartilage

The normal topographic relationships of the anterolateral surface of the arytenoid cartilage (ALSAC) were reinvestigated with special regard to possible implications involving the extensions of local cancer. Serial plastinated whole-organ sections of 34 normal adult larynges were examined. A cartilaginous crest subdivided the ALSAC into a cranial triangular fossa and a caudal oblong fossa and provided attachment to the lateral fibers of the vocal cord. The thyroarytenoid muscle was mainly anchored within the oblong fossa, but a few lateral muscle fibers extended further cranial ward along the ALSAC. The triangular fossa was the area of fixation of the vestibular ligament and was filled with adipose tissue as well as mucous glands grouped together by strong collagenous fiber septa. These septa revealed a craniocaudal orientation medially and a horizontal anteroposterior orientation laterally. These findings suggest that the septa guide early local cancer extension parallel to their own arrangement, acting as barriers that cannot be easily crossed. Correspondingly, cranial and horizontal-lateral cancer spread along the ALSAC has been reported in the clinical literature. Received: 21 July 1997 / Accepted: 26 September 1997