A Newly Discovered Tendon Between the Genioglossus Muscle and Epiglottic Cartilage Identified by Histological Observation of the Pre-Epiglottic Space.
A Newly Discovered Tendon Between the Genioglossus Muscle and Epiglottic Cartilage Identified by Histological Observation of the Pre-Epiglottic Space.
复制标题
通过组织学观察到斑点前空间，肌肉和表格软骨之间的新发现的肌腱与表面性软骨之间的肌腱之间。
作者：
会厌后倾很难从解剖学上解释。原因之一是会厌前粘膜下组织（会厌前间隙，PES）的韧带结构识别不足。虽然研究表明舌根运动在会厌后倾中起作用，但很少有形态学报道研究舌肌与会厌的附着。本研究通过全面分析PES中的纤维排列，重建PES的纤维结构，重点是舌肌和会厌之间的舌骨会厌韧带。对20具尸体（男10例，女10例;平均年龄79岁）舌至喉的粘膜下结构进行了大体和显微观察。在会厌的中线区域发现了一条肌腱，从颏舌肌的后部延续并附着于会厌软骨的中心。我们将此肌腱命名为舌会厌肌腱。与此相反，舌骨会厌韧带位于舌骨和会厌之间，从会厌软骨的外侧缘连接到会厌软骨的基部。此外，舌会厌肌腱由高密度纤维束组成，其比舌骨会厌韧带粗。这些结果表明，传统的舌骨会厌韧带具有两层结构，由连接至颏舌肌的上部纤维束和连接至舌骨的下部纤维束组成。因此，颏舌肌后部的持续收缩使会厌处于持续牵引下，这表明其松弛可能导致会厌后倾。
Epiglottic retroversion is difficult to explain anatomically. One reason is inadequate structural identification of the ligaments in the submucosal tissue anterior to the epiglottis (pre-epiglottic space, PES). Although studies have shown that tongue root movement plays a role in epiglottic retroversion, few morphological reports have investigated the attachment of the lingual muscles to the epiglottis. This study reconstructed the fiber structure of the PES by comprehensively analyzing fiber alignment in the PES focusing on the hyoepiglottic ligament, which runs between the lingual muscles and the epiglottis. Gross and microscopic observations of the submucosal structures from the tongue to the larynx of 20 cadavers (10 men, 10 women; mean age 79 years) were performed. A tendon continuing from the posterior part of the genioglossus muscle and attaching to the center of the epiglottic cartilage was identified in the midline area of the epiglottis. We named this tendon the glossoepiglottic tendon. In contrast, the hyoepiglottic ligament is found between the hyoid bone and the epiglottis and is attached from the lateral margin of the epiglottic cartilage to its base. Furthermore, the glossoepiglottic tendon consists of a high-density fiber bundle that is thicker than the hyoepiglottic ligament. These results show that the conventional hyoepiglottic ligament has a two-layer structure consisting of an upper fiber bundle connected to the genioglossus muscle and a lower fiber bundle connected to the hyoid bone. Sustained contraction of the posterior part of the genioglossus muscle therefore places the epiglottis under persistent traction, suggesting that its relaxation may cause epiglottic retroversion.
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DOI：
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