Anatomical definition of the subglottic region
Anatomical definition of the subglottic region
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DOI：
10.1159/000099628
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发表时间：
2006-01-01
影响因子：
2.7
通讯作者：
Paulsen, Friedrich
中科院分区：
文献类型：
--
作者：
Kutta, Hannes;Steven, Philipp;Paulsen, Friedrich
背景：由于喉部肿瘤，以及感染性和自身免疫性疾病，声门下区具有重要的临床意义。然而，对声门下结构的描述是不一致的。我们研究的目的是提供对声门下区的精确分析，并得出功能和临床结论。方法：对33例供体喉声门下区组织进行组织学、组织化学、免疫组织化学及扫描电子显微镜检查，并结合注射技术进行观察。结果：重新定义了声门下区的三维延伸：声带下弧线被定义为颅缘。环状软骨的下缘是尾缘。在颅侧，弹性锥体和更远的尾部，环状软骨形成边界。因此，提出的定义包括迄今未命名的下喉腹侧和背侧部分。声门下区可以被描述为圆柱形，沿着弹性锥体沿颅面方向变小。腹侧边界由环甲状韧带的中段(圆锥韧带)形成，背侧部分由环状软骨形成。声门下壁分为三层或四层，由胶原纤维和弹性纤维组成，其中嵌入浆膜粘液腺。声门下血管包括紧密的上皮下毛细血管丛。结论：对声门下区的新定义有助于喉部肿瘤的准确分类。结果表明，边界不太可能抵消声门下肿瘤的进展。此外，这些发现表明，这些结构有助于调节呼吸的温度，防止炎症，以及呼吸频率和深度依赖的粘液分泌。版权所有(C)2007 S.Karger AG，巴塞尔。
Background: Due to laryngeal neoplasia, as well as infectious and autoimmune diseases, the subglottic region is of great clinical relevance. However, descriptions of the subglottic structures are inconsistent. The aim of our study was to present a precise analysis of the subglottic region and derive functional and clinical conclusions. Methods: Histological, histochemical and immunohistochemical investigations as well as scanning electron microscopy were performed and combined with injection techniques applied to the subglottic region of the larynges of 33 body donors. Results: The three-dimensional extensions of the subglottic region were newly defined: the inferior arcuate line of the vocal cord was defined as the cranial border. The lower margin of the cricoid is the caudal border. Craniolaterally, the elastic cone and, further caudally, the cricoid form the border. Therefore, the definition presented comprises heretofore unnamed ventral and dorsal parts of the lower larynx. The subglottic region can be described as cylindrical, becoming smaller in the cranial direction, following the elastic cone. The ventral boundary is formed by the median part of the cricothyroid ligament (ligamentum conicum), the dorsal part by the cricoid cartilage. The walls of the subglottis are divided into three or four layers composed of collagenous and elastic fibres in which seromucous glands are embedded. Subglottic blood vessels including a tight subepithelial capillary plexus were delineated. Conclusion: The new definition of the subglottic extensions presented is helpful and essential for precise laryngeal tumour classification. The results indicate that the boundaries are unlikely to counteract tumour progression in the subglottis. Furthermore, the findings suggest that these structures contribute to temperature regulation of breath, protection against inflammation as well as breath frequency and depth-dependent mucus secretion. Copyright (c) 2007 S. Karger AG, Basel.