The larynx, commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about 4–5 centimeters in diameter. The larynx houses the vocal cords, and manipulates pitch and volume, which is essential for phonation. It is situated just below where the tract of the pharynx splits into the trachea and the esophagus. The word 'larynx' comes from the Ancient Greek word lárunx ʻlarynx, gullet, throat.ʼ
The recurrent laryngeal nerve (RLN) is a branch of the vagus nerve that supplies all the intrinsic muscles of the larynx, with the exception of the cricothyroid muscles. There are two recurrent laryngeal nerves, right and left. The right and left nerves are not symmetrical, with the left nerve looping under the aortic arch, and the right nerve looping under the right subclavian artery then traveling upwards. They both travel alongside the trachea. Additionally, the nerves are among the few nerves that follow a recurrent course, moving in the opposite direction to the nerve they branch from, a fact from which they gain their name.
The rima glottidis is the opening between the two true vocal cords anteriorly, and the two arytenoid cartilages posteriorly. It is part of the larynx.
The lateral cricoarytenoid is an intrinsic muscle of the larynx. It attaches at the cricoid cartilage anteriorly, and at the arytenoid cartilage of the same side posteriorly. It is innervated by the recurrent laryngeal nerve. It acts to close the rima glottidis, thus closing the airway.
The cricoid cartilage, or simply cricoid or cricoid ring, is the only complete ring of cartilage around the trachea. It forms the back part of the voice box and functions as an attachment site for muscles, cartilages, and ligaments involved in opening and closing the airway and in producing speech.
The cricothyroid muscle is the only tensor muscle of the larynx aiding with phonation. It is innervated by the superior laryngeal nerve. Its action tilts the thyroid forward to help tense the vocal cords, thus increasing the pitch of the voice.
The arytenoid cartilages are a pair of small three-sided pyramids which form part of the larynx. They are the site of attachment of the vocal cords. Each is pyramidal or ladle-shaped and has three surfaces, a base, and an apex. The arytenoid cartilages allow for movement of the vocal cords by articulating with the cricoid cartilage. They may be affected by arthritis, dislocations, or sclerosis.
The inferior pharyngeal constrictor muscle is a skeletal muscle of the neck. It is the thickest of the three outer pharyngeal muscles. It arises from the sides of the cricoid cartilage and the thyroid cartilage. It is supplied by the vagus nerve. It is active during swallowing, and partially during breathing and speech. It may be affected by Zenker's diverticulum.
The stylopharyngeus muscle is a muscle in the head. It originates from the temporal styloid process. Some of its fibres insert onto the thyroid cartilage, while others end by intermingling with proximal structures. It is innervated by the glossopharyngeal nerve. It acts to elevate the larynx and pharynx, and dilate the pharynx, thus facilitating swallowing.
The arytenoid muscle or interarytenoid muscle is a composite intrinsic muscle of the larynx, consisting of a transverse part and an oblique part - the two parts may be considered as separate muscles: an unpaired transverse arytenoid muscle, and a bilaterally paired oblique arytenoid muscle.
The aryepiglottic muscle or aryepiglotticus muscle is an intrinsic muscle of the larynx.
The oblique arytenoid is bilaterally paired intrinsic muscle of the larynx. It is superficial to the transverse arytenoid; the oblique and transverse arytenoids are often considered two parts of a single muscle - the interarytenoid muscle.
The inferior thyroid artery is an artery in the neck. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle. It then turns medially behind the carotid sheath and its contents, and also behind the sympathetic trunk, the middle cervical ganglion resting upon the vessel.
The superior laryngeal nerve is a branch of the vagus nerve. It arises from the middle of the inferior ganglion of vagus nerve and additionally also receives a sympathetic branch from the superior cervical ganglion.
The aryepiglottic folds are triangular folds of mucous membrane of the larynx. They enclose ligamentous and muscular fibres. They extend from the lateral borders of the epiglottis to the arytenoid cartilages, hence the name 'aryepiglottic'. They contain the aryepiglottic muscles and form the upper borders of the quadrangular membrane. They have a role in growling as a form of phonation. They may be narrowed and cause stridor, or be shortened and cause laryngomalacia.
The transverse arytenoid is an unpaired intrinsic muscle of the larynx. It is situated deep to the two oblique arytenoids; the oblique and transverse arytenoids are often considered two parts of a single muscle - the interarytenoid (arytenoid) muscle.
In the human larynx, the vocal process is the anterior angle of the base of the arytenoid cartilage, as it projects horizontally forward and gives attachment to the vocal ligament.
Endoscopic laser cordectomy, also known as Kashima operation, is an endoscopic laser surgical procedure performed for treating the respiratory difficulty caused as a result of bilateral abductor vocal fold paralysis. Bilateral vocal fold paralysis is basically a result of abnormal nerve input to the laryngeal muscles, resulting in weak or total loss of movement of the laryngeal muscles. Most commonly associated nerve is the vagus nerve or in some cases its distal branch, the recurrent laryngeal nerve. Paralysis of the vocal fold may also result from mechanical breakdown of the cricoarytenoid joint. It was first described in by Kashima in 1989.
Thyroplasty is a phonosurgical technique designed to improve the voice by altering the thyroid cartilage of the larynx, which houses the vocal cords in order to change the position or the length of the vocal cords.
Arytenoid adduction is a surgical procedure used to treat vocal cord paralysis. A suture is used to emulate the action of the lateral cricoarytenoid muscle and position the paralyzed vocal cord closer to the midline. This allows the two vocal cords to meet and can improve speaking and swallowing ability for affected patients. Arytenoid adduction is often performed in conjunction with medialization thyroplasty.
