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The vertebral level of the arytenoid cartilages.

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The Vertebral Level of the Arytenoid Cartilages
HAROLD J. KOPPEL,' GEORGE S. KENDRICK AND
JAMES E. MORELAND
Department of A n a t o m y , Baylor University College of Dentistry,
Dallas, T e x a s
ABSTRACT
A group of 27 females and 24 males between the ages of eight years
four months and 15 years seven months was examined to determine the vertebral
level of their arytenoid cartilages. A n appraisal of their lateral cephalometric radiographs which included the cervical vertebra was made under rigid conditions. Each
cervical vertebra was divided into three sections in order to relate its position more
precisely to the cartilages. The age of each subject was recorded and then compared
with the vertebral level of their arytenoid cartilages. General consistency seemed to
prevail throughout the group at given sex and age levels. Visualization of the arytenoid
cartilages was excellent. No evidence of mineralization in the laryngeal cartilages was
noted in the age group studied.
Although most of the current anatomy
texts, such as Gray ('66), Cunningham
('64), Grant ('62), Lockhart, Hamilton
and Fyfe ('59), describe the vertebral
level of the cricoid cartilage, they fail to
give the position of the arytenoid cartilages.
It could be left to the assumption that
location of the cricoid cartilages, which
are described rather thoroughly, would
suffice for the arytenoids, since they are
contiguous. Therefore, due to descriptive
inconsistencies of these cartilages with
respect to their vertebral level as recorded
in anatomy texts, the present study was
undertaken.
MATERIALS AND METHOD
The lateral cephalometric radiographs
on 51 subjects, 27 females and 24 males,
between the ages of eight years four
months and 15 years seven months were
utilized. These radiographs were taken
with the teeth in occlusion and according
to the methods of Broadbent ('31), Hixon
('60), Knowles ('62) and Thurow ('51).
Exposure and developing were kept constant to standardize the quality of the
radiographs.
All of the subjects were Caucasoid and
without musculoskeletal or other determinable defects. There were no siblings,
Negroid or Mongoloid individuals in the
group.
Accurate tracings were made of each
subject by extending a line through the
ANAT. REC., 160: 583-586.
base of the arytenoid cartilage to one of
the three parts of the corresponding vertebra (figs. 1, 2). Following the completion
of these tracings, another person was selected to trace a sample group to see if
there was a variation in the method. The
tracings made by him were compared
with the original group. There was such
close similarity in the interpretation of the
arytenoid-vertebra relation that the present
study was completed.
OBSERVATIONS
The chief finding of this study on 27
females and 24 males revealed the vertebral level of the arytenoid cartilages to
vary with age and sex (fig. 3 ) . However,
39 of the 51 subjects studied were seen to
exhibit less than one vertebra difference in
the vertebral level of their aryteniod cartilages. There was no constant descent with
age (fig. 3 ) ; nor was it shown that the arytenoids are at a higher vertebral level in
males than in females of the same age.
DISCUSSION
The inferior limit of the larynx and the
beginning of the trachea and esophagus
corresponds to the lower border of the
cricoid cartilage. Luschka (1871), Rudinger (1873) and Braune (1875) illustrated this level at the lower border of the
sixth cervical vertebra in the adult, with
IThesis submitted in partial fulfillment of the requirements for the degree of Master of Science in
Dentistry, Baylor University College of Dentistry, 1967.
583
584
HAROLD J. KOPPEL, GEORGE S . KENDRICK AND JAMES E. MORELAND
Fig. 1
A typical radiograph used in this study illustrating the arytenoid cartilages.
Soft palate
Spine of atlas
Tongue
Tip of epiglottis
Body of hyoid bone
Arytenoid eminence
and lower thirds
Fig. 2
A typical tracing of the arytenoid cartilages illustrating division of the cervical vertebra.
585
THE ARYTENOID CARTILAGES
Males
Females
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AGE I N YEARS
Fig. 3 A graph illustrating the vertebral level of the arytenoid cartilages in male and female
subjects.
the head erect. Rudinger (1873) also
noticed that the level was higher in infants.
Symington (1881-1885) postulated that
this downward displacement in adults is
caused by the growth of the facial portion
of the skull and not by the vertical growth
of the larynx exceeding that of the vertebral column during growth from childhood
to adulthood. He concluded that at puberty
the larynx has achieved its adult position.
Lisser ('11-'12), Testut ('14) and
Rouvi2re ('24) also observed a gradual
descent of the larynx with age but the latter included the observation that the laryngeal position was lower in males than in
females of the same age.
Negus ('49), disagreeing with Symington (1881-1851), postulated that laryngeal
descent is due to an assumption of erect
posture and recession of the jaws. He also
observed that the larynx terminated opposite the middle of the sixth cervical vertebra in a seven month old fetus and in a
newborn.
Bench ('63) however, stated that the
larynx terminates between the third and
fourth cervical vertebra in the newborn.
He also established a close relation of
vertical growth of the face to growth of the
neck in preschool and postpubertal groups,
According to him a higher correlation exists in postpubertal ages. Thompson and
Kendrick ('64) have shown the face to
exhibit vertical growth in the third and
fourth decades of life. While no mention
of the larynx was made, changes in this
area may also occur.
That females usually reach puberty
ahead of males is well documented. For
this reason, one may assume the arytenoid
cartilage of the female group to be inferior
to the males of the equivalent age. This
occurrence was not consistently recorded
in the present study.
CONCLUSIONS
An attempt has been made to relate the
arytenoid cartilages to the cervical vertebra
while using the living subject. A review
of literature has failed to present this relation. That the cricoarytenoid cartilage
complex may continue to descend after
puberty is suggested on the basis of the
present study. While some variation exists, consistency was ever present in the
arytenoid-vertebra relation when sex and
age were considered. Hopefully, it will not
be too long before more information is
586
HAROLD J. KOPPEL, GEORGE S . KENDRICK AND JAMES E. MORELAND
presented on the relation of these anatomical structures.
LITERATURE CITED
Bench, R. W. 1963 Growth of the cerical vertebra as related to tongue, face, and denture behavior. Am. J. Orthodont., 48: 183-214.
Braune, H. 1875 Topographisch-anatomischer
atlas.
Broadbent, €3. H. 1931 A new x-ray technique
and its application to orthodontia. Angle
Orthodont., 1: 45-66.
Goss, C. M. 1966 Gray's anatomy. Lea and
Febiger, Philadelphia.
Grant, J. C. B. 1962 A n atlas of anatomy. 5th
ed., The Williams and Wilkins Co., Baltimore.
Hixon, E. H. 1960 Cephalometric and longitudinal research. Am. J. Orthodont., 46: 3642.
Knowles, C. C. 1961 Cephalometric studies of
the skull. Brit. J. Plast. Surg., 14: 315-324.
Lisser, H. 1911-1912 Studies on the development of the human larynx. Am. J. Anat., 12:
27-66.
Lockhart, D., J. Hamilton and T. Fyfe 1959
Anatomy of the human body. J. P. Lippincott
Co., Philadelphia.
Luschka, P. 1871 Der Kehlkopf des Menschen.
Tiibingen.
Negus, V. E. 1949 The comparative anatomy
and physiology of the larynx. Grune and Stratton, Inc., New York.
Romanes, J. J. 1964 Cunningham's textbook of
anatomy. 10th ed., Oxford University Press,
New York.
RouviBre, H. 1924 Anatomie humaine descriptive et topographique. Masson et Cie, Paris.
Rudinger, H. 1873-1875 Topographisch-chirungische Anatomie des Menschen. 2nd ed.,
Stutgart.
Symington, J. 1881 On the anatomical relations of the trachea in the child. Edinburgh
Med. J.
1885 On the relations of the larynx
and trachea to the vertebral column in the fetus
and child. J. Anat. Physiol., 19: 286-291.
Testut, J., and 0. Jacob 1914 Traite d'anatomie
topographique avec applications medico-chirurgicales. 0. Doin Co., Paris.
Thompson, J. L., Jr., and G. S. Kendrick 1964
Changes in the vertical dimensions of the human male skull during the third and fourth
decades of life. Anat. Rec., 150: 209-214.
Thurow, R. C. 1951 Cephalometric methods in
research and private practice. Angle Orthodont.,
21: 104-116.
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