Anatomic Considerations for a Posterior Endoscopic Approach to the Cricoarytenoid Joint

Area of Science:

• Anatomy
• Surgical Approaches
• Laryngology

Background:

• The cricoarytenoid joint (CAJ) is crucial for vocal fold function.
• Disorders of the CAJ can lead to significant voice problems.
• Minimally invasive surgical approaches are desirable for CAJ interventions.

Purpose of the Study:

• To assess the feasibility of a posterior endoscopic approach to the cricoarytenoid joint (CAJ).
• To define the anatomical relationships between landmarks and the posterior CAJ space.
• To provide data supporting potential new CAJ procedures.

Main Methods:

• Anatomic study of six adult cadaver larynges.
• Measurements of the posterior CAJ space using digital calipers.
• Angle calculations performed with Image J software.
• Successful injection of CAJ with colored gel via a posterior approach.

Main Results:

• The average posterior CAJ space (pCAJs) length was 4.95 mm.
• Key distances from landmarks (midline cricoid lamina, corniculate cartilage) to the pCAJs were measured.
• The average angle of declination of the pCAJs was 54°.
• All 12 cricoarytenoid joints were successfully accessed and injected.

Conclusions:

• The posterior CAJ space is surgically locatable using identifiable anatomical landmarks.
• Understanding this anatomy can improve intra-articular injection consistency.
• This approach may facilitate new procedures for vocal fold motion and malposition disorders.