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General Surgery

Larynx

Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery

What’s inside

14 sections · 190 slides

  1. 01

    Overview

    • Scope of this presentation

    1 slide

  2. 02

    Development of the larynx

    • Respiratory primordium and the laryngotracheal groove
    • Arytenoid and epiglottic swellings
    • Occlusion and recanalisation of the laryngeal lumen
    • Origin of the laryngeal cartilages and muscles
    • Sequence of laryngeal development
    • Stages in the development of the larynx
    • Congenital anomalies of the larynx
    • Surgical treatment of congenital laryngeal anomalies
    • Anomalies of the Larynx

    9 slides

  3. 03

    The adult larynx

    • Constituents of the laryngeal apparatus
    • Adult larynx in situ
    • Extent of the laryngeal cavity
    • Supraglottic space
    • Glottic and subglottic spaces
    • The three internal storeys of the larynx
    • Coronal section through the laryngeal cavity
    • Topography and vertebral relations
    • Anterior and lateral relations of the larynx
    • Posterior relations and the recurrent laryngeal nerve landmark
    • Proximal and distal topography of the larynx
    • Dimensions of the larynx
    • Average Measurements of the Larynx

    13 slides

  4. 04

    Skeletal anatomy

    • Hyoid bone: role in the laryngeal apparatus
    • Form and relations of the hyoid bone
    • The hyoid bone
    • Thyroid cartilage: laminae and laryngeal prominence
    • Cornua and tubercles of the thyroid cartilage
    • Oblique line and its muscular attachments
    • Ligaments attached to the thyroid cartilage
    • Cartilages and ligaments of the larynx from the front
    • Cricoid cartilage: form and level
    • Articulations and attachments of the cricoid
    • Muscle attachments and reconstruction of the cricoid
    • Cartilages and ligaments of the larynx from behind
    • Arytenoid cartilages: shape and processes
    • Surfaces of the arytenoid and their attachments
    • Motion at the cricoarytenoid articulation
    • Cricoarytenoid articulation: findings of Prades et al.
    • Sliding and rocking at the cricoarytenoid articulation
    • Corniculate, cuneiform and tritiate cartilages
    • Epiglottic cartilage
    • Preglottic space and folds of the epiglottis
    • Acute epiglottiditis
    • Disarticulated and approximated laryngeal cartilages

    22 slides

  5. 05

    Ligaments, membranes and folds

    • Thyrohyoid membrane
    • Superior laryngeal neurovascular bundle
    • Thyrohyoid membrane and the superior laryngeal neurovascular bundle
    • Quadrangular membrane
    • Interarytenoid notch
    • Quadrangular membrane seen from behind
    • Vestibular folds (false vocal cords)
    • Functions of the vestibular folds
    • Aryepiglottic folds
    • Cricothyroid ligament (conus elasticus)
    • Attachments of the cricothyroid ligament
    • Shape of the conus elasticus and the anterior commissure
    • Vocal ligaments and vocal cords
    • Vocal fold and the rima glottidis
    • Dimensions and mobility of the glottis
    • Absence of lymphatics in the vocal cord epithelium
    • Interior of the larynx and the vocal folds
    • Cartilages and ligaments of the larynx in sagittal section
    • Valleculae and the glossoepiglottic folds
    • Laryngeal mucosa

    20 slides

  6. 06

    Laryngeal spaces

    • Classification of the laryngeal spaces
    • Laryngeal vestibule
    • Laryngeal ventricles and the saccule
    • Glottis and rima glottidis: endoscopic dimensions
    • Laryngocele
    • Types of laryngocele
    • Combined internal and external laryngocele
    • Treatment of laryngoceles
    • Subglottic (infraglottic) space
    • Boundaries of the subglottic region and routes of tumour escape
    • Paraglottic space
    • Pre-epiglottic space
    • Spread of supraglottic carcinoma
    • The larynx viewed from above
    • Mirror view of the larynx from above

    15 slides

  7. 07

    Laryngeal joints

    • Cricothyroid joint
    • Cricoarytenoid joint: adduction and abduction
    • Rocking motion and vocal cord tension

    3 slides

  8. 08

    Laryngeal muscles

    • Extrinsic laryngeal muscles
    • Extrinsic laryngeal or strap muscles
    • Cricothyroid muscle
    • Cricothyroid action during phonation and swallowing
    • Posterior cricoarytenoid muscle
    • Lateral cricoarytenoid and arytenoid muscles
    • Sphincteric action of the oblique arytenoid fibres
    • Thyroarytenoid and vocalis muscles
    • Thyroepiglotticus muscle
    • Intrinsic muscles of the larynx
    • Glottic motion during respiration and phonation
    • Regulation of voice pitch and tone
    • Laryngeal position when humming a low and a high tone
    • Lengthening of the vocal cord by tilting the cricoid cartilage

    14 slides

  9. 09

    Vascular system and lymphatics

    • Superior and inferior laryngeal arteries
    • Cricothyroid artery and laryngeal anastomoses
    • Arterial blood supply of the larynx
    • Venous drainage of the larynx
    • Venous drainage from the larynx
    • Lymphatic drainage of the larynx
    • Cadaveric findings on laryngeal lymphatic pathways
    • Ranke's space and the lymphatic-free vocal fold
    • Lymphatic drainage of the larynx

    9 slides

  10. 10

    Innervation

    • Vagal nerve supply to the larynx
    • External laryngeal nerve
    • Internal laryngeal nerve
    • Recurrent laryngeal nerve
    • Nerve supply of the larynx
    • Nerve supply of the larynx
    • One pattern of distribution of the inferior laryngeal nerve
    • Sensory territories of the pharynx and larynx
    • Density of sensory innervation in the pharynx
    • Sympathetic supply to the larynx
    • External laryngeal nerve: the plane of safety
    • Identification of the recurrent laryngeal nerve
    • Vascular supply of the vagus and apparent nerve injury
    • Course of the recurrent laryngeal nerve in the neck
    • Functional changes with laryngeal nerve injury
    • Signs and Symptoms of Laryngeal Nerve Injury
    • Laryngoscopic appearances of the types of laryngeal nerve injury

    17 slides

  11. 11

    Pediatric larynx and histology

    • Size of the pediatric larynx
    • Shape and position of the infant larynx
    • Consistency of the pediatric larynx
    • Infant larynx compared with the adult larynx
    • Histology of the laryngeal epithelium
    • Distribution of the laryngeal mucous glands
    • Physiology of the larynx

    7 slides

  12. 12

    Anatomic complications

    • Aspiration after supraglottic laryngectomy
    • Patient selection for supraglottic laryngectomy
    • Glottic stenosis versus glottic incompetence
    • Swallowing rehabilitation after supraglottic laryngectomy
    • Complications of vertical hemilaryngectomy
    • Prevention and management of glottic stenosis
    • Foreshortening of the glottis
    • Pharyngocutaneous fistula after total laryngectomy
    • Management and other causes of fistula
    • Neopharyngeal stenosis and tracheal stomal stenosis
    • Bleeding and carotid blowout
    • Voice loss and voice restoration
    • Granulation tissue after tracheal resection
    • Nerve injury during airway reconstruction
    • Wound separation and laryngeal release
    • Steps of a laryngeal release
    • Laryngeal trauma

    17 slides

  13. 13

    Anatomic and surgical history

    • Reading the historical record of laryngeal surgery
    • Anatomic and Surgical History of the Larynx
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)
    • Anatomic and Surgical History of the Larynx (continued)

    22 slides

  14. 14

    Summary

    • Key anatomical points
    • Key surgical points
    • Works cited in the text
    • Works cited in the text (continued)
    • Works cited in the text (continued)
    • Works cited in the text (continued)
    • Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
    • Join our WhatsApp groups

    8 slides