Clinical implication of vascular and dimensional aspects of the cricothyroid space in the Turkish population

OBJECTIVE: Cricothyroid space (CS) is one of the thinnest part in the framework of the larynx. The close relations of CS to the intralaryngeal subglottic area increase its anatomical importance. The aim of this study was to establish topographic distribution and the number of perforating vessels lying towards the intralaryngeal subglottic region and finding the calibrations of these vessels, thus revealing an index for the Turkish population.

METHODS: In this study, 5 women and 45 men autopsy materials that had no pathology or previous surgery in the area were examined during the period February to November 2003. All specimens in this study were selected randomly from the criminal lab of the Republic of Turkey Ministry of Justice, Istanbul, Turkey. Microdissections were made by SMZ 10 Stereomicroscope. Superficial vascular structures of the membrane cricothyroidea at CS and their crossing places (foramens) to the intralaryngeal area, their numbers and localizations in relation to the midline (right/left and cranial/caudal) and their diameters were established.

RESULTS: In the larynx dissections, which were made in 50 cases, a total of 180 vessels were seen. Seventy-eight vessels were situated on the middle line (cranial and caudal). Fifty-three vessels were at right side (cranial and caudal) and 49 vessels were at left side (cranial and caudal). In 20 specimens 2-4 vessels arrangement were passing through the foramen to the intralaryngeal subglottic area. Among these foramens, 20 of them consisted of 2 vessels (16 cranial, 4 caudal), 4 of 3 vessels (3 cranial, 1 caudal) and only one foramen was consist of 4 vessels (cranial).

CONCLUSION: The cricothyroid area is an anatomical compartment enclosed by a connective tissue membrane and connected to the adjacent laryngeal region by vessels. This region is important with regard to surgical procedures, spread of laryngeal cancer and traumatic lesions of the larynx. Therefore, the clinical and surgical importance of vascular anatomy and the dimension of the cricothyroid space should be given emphasis in our population.