Larynx – structure, functions, diseases, diagnostics. Where is the larynx?

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The larynx is a small cartilage structure that connects the throat to the trachea. It is located at the front of the neck and houses the vocal cords, producing speech sounds and contributing to breathing. The larynx is about 4-5 centimeters long and wide. The larynx can be affected by many conditions, including laryngitis.

Where is the larynx?

The position of the larynx changes with the age of a person. In infancy, it is located behind the jaw between the soft palate – the back of the palate – and the epiglottis. The epiglottis is a small piece of cartilage that closes the trachea when a person swallows. As a person matures, the larynx moves back and down the throat. In adulthood, it is located approximately halfway down the neck below the epiglottis and above the trachea.

Larynx – structure

The larynx is a complex complex of cartilage, ligaments, muscles and mucosa. The hollow structure consists of three large sections of cartilage that are unpaired – the thyroid gland, annular, and epiglottis – as well as six smaller cartilages. We divide large cartilages into:

1. thyroid cartilage: this largest cartilage of the larynx consists of the anterior and lateral parts of its structure. The right and left halves (gills) come together in the midline to form a forward protrusion – the bulge of the larynx, which is commonly known as the Adam’s apple. This structure is most noticeable in men after puberty and is located just below the upper notch of the thyroid gland and just above the lower notch of the thyroid which is at the base of this cartilage. The back sides of each lamina curl up into the upper corner and down into the smaller, lower corner. The first, as well as the upper edge of the larynx, attach to the hyoid bone through the thyroid gland. The lower horn is adjacent to the posterior, lateral edge of the cricoid cartilage.
2. cricoid cartilage: is located just below the thyroid cartilage, the cricoid cartilage is ring-shaped and surrounds the airways; represents the lower larynx. It is narrower at the front and wider at the rear, with a centerline that serves as the esophagus anchor point. This cartilage attaches to the thyroid cartilage via the cricothyroid ligament and to the trachea via the cricotracheal ligament. Importantly, two paired, pyramidal tincture cartilages are located along the upper, lateral portions of the wider annular portion.
3. epiglotting cartilage: this leaf-shaped cartilage is covered with a mucosa and is connected to the angle formed by the sides of the thyroid cartilage by the thyroid-epiglotting ligament. It is also connected to the hyoid bone along the hyoid-epiglottic ligament that runs from the upper anterior surface of the epiglottis. The top edge of this structure is in the throat, just below the base of the tongue. As such, it is located just above the opening of the larynx, which contributes to its essential function when swallowing. A layer of connective tissue, a quadrilateral membrane, runs between the upper, lateral edges of the epiglottis and the sides of the tincture cartilage. The slowly hanging lower edge is thicker and forms the atrial ligament, which is surrounded by the mucosa, thus forming vestibular folds. This fold, in turn, connects to the thyroid and tincture cartilage.

There are also some free hanging cartilages, sphenoid cartilage, located in a membrane called the epiglottic tincture, which represents the top edge of the membrane that connects the tincture cartilage to the epiglottis. It is covered with mucus and forms a structure called the epiglottis fold.

It is also important to look inside the larynx, which is the laryngeal cavity, which houses important structures, including the vocal cords. This space extends along the opening to the bottom of the cricoid; it is thinner in the middle and wider at the top and bottom. Anatomically, it is divided into three sections:

1. supraglottic section: the vestibule of the laryngeal cavity is located between the laryngeal opening and the vestibular folds. The part, lined with mucus, is located just above the vocal folds formed by the vestibular ligament extending from the epiglottis.
2. glottis: this part of the larynx, also known as the glottic space, is bounded by the vestibular folds at the top and the vocal cords at the bottom. The walls of this portion bulge to form recessed areas on the sides known as the laryngeal chambers that have extensions called sacs that extend forward and upward. They are lined with mucus necessary for vocalization. The vocal cords are four strands of flexible, fibrous tissue, two of which are upper and two lower. The former, also known as false vocal cords, are thin and ribbon-shaped with no muscle components, while the latter are wider and have muscles covering them. It is the lower vocal cords that are able to come closer together, which is necessary for the sound to be produced. The opening between these structures is called the glottis gap.
3. subglottic cavity: defined as the space below the glottis and above the windpipe, this part of the larynx begins to expand as it runs downward.

It is worth noting that the larynx is associated with two groups of muscles – external and internal. The first of them move the entire structure and move the hyoid bone, bending when swallowing and vocalizing. The inner muscles, on the other hand, are much smaller and are involved in moving the vocal cords when breathing, vocalizing and swallowing.

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Larynx – functions

The larynx is primarily an organ associated with vocalization and the making of sounds. Basically, when we exhale, air is forced through the glottis, and it is the vibrations of the vocal cords that produce the sound.

When speaking or vocalizing, the position of these vocal cords changes to affect pitch and loudness, which can be further modulated by the tongue and relative position of the mouth, depending on our needs.

Additionally, the larynx plays an important role in preventing food from getting stuck in the airways. When people swallow, the epiglottis moves downwards, blocking the trachea. The food or fluid then travels to the esophagus, which runs along the trachea and supplies the food to the stomach.

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Larynx – ailments

A wide variety of conditions can be associated with the larynx, from inflammation caused by disease to cancer. These include, in particular, the diseases of the larynx listed below.

Larynx diseases – laryngitis

Laryngitis can be chronic – that is, lasting more than three weeks – or acute, the former being more common. Symptoms of this condition include hoarseness, pain, cough and, in some cases, fever. Acute laryngitis is often the result of a viral or bacterial infection of the upper respiratory tract, with a significant number of cases being the result of fungal growth.

Chronic cases are usually the result of smoking, allergies, or acid reflux. People who use their voice frequently, such as singers, teachers, and other professions, may experience laryngitis due to abuse of this organ.

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Larynx diseases – paralysis of the vocal folds

As a result of the paralysis of the laryngeal nerve that innervates the inner muscles of the larynx, vocal fold paralysis is the result of a number of conditions, including head or neck trauma, stroke, tumors, infection, or other neurological problems. As a result, it can have a severe impact on speech and vocal function. This condition sometimes resolves on its own, although speech and language therapy or treatment of the underlying causes may be necessary to resolve the problem.

Larynx diseases – laryngeal cancer

This form of cancer arises in the glottis and, like others, can spread aggressively. This leads to hoarseness, voice changes, lump formation in the neck, coughing and difficulty swallowing. As with other cancers, patients undergo surgery, chemotherapy, or radiation therapy.

Larynx – diagnosis

Accurate assessment of the larynx is essential for the correct diagnosis of any medical condition and its overall functioning. Among the diagnostic methods of the larynx, the following are distinguished:

1. Indirect laryngoscopy: a test that has been in use for over a century, this approach involves inserting a special mirror into the back of the mouth to allow professionals to visually evaluate the larynx. The test is performed while the patient swallows, speaks, or sings to assess problems such as vocal fold paralysis or functional problems due to neurological conditions, among other things.
2. direct laryngoscopy: The most widely used examination, laryngoscopy involves the use of a tool called an endoscope (basically a specialized tube with a camera at the end) that is inserted through the nostril to capture images of the inside of the larynx. The examination is performed in the operating room under general anesthesia.
3. stroboscopy: the test involves the use of a specialized microphone placed on the skin just above the larynx. This device records the frequency of the voice and translates it into a strobe light that flashes out of sync with that frequency, creating a video image of the movement of the vocal folds. This method is ideal for analyzing problems with the health of the surface of the vocal cords, such as lesions.

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