THE PREEPIGLOTTIC SPACE: ITS RELATION TO CARCINOMA OF THE EPIGLOTTIS

Laryngologists long have recognized that the thyroid cartilage, a hyaline structure, which commonly exhibits ossification in adult life, is an effective barrier against anterior invasion by a cancer of a vocal cord. Perforation of the cartilage may occur late in the disease but then it usually is associated with pyogenic infection. Cancer occurring in other parts of the larynx commonly extends more rapidly beyond its primary site. One of the reasons is absence of an effective limiting barrier. The extension of cancer therefore is not dependent entirely on histologic structure and lymphatic drainage but also on tissue barriers. The anterior part of the supraglottic larynx corresponding to the lower one half of the epiglottis and the anterior extremity of a ventricular band is the second most common site of laryngeal cancer. This usually is referred to as vestibular cancer. In this area it is prone to invade anteriorly as well