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Aryepiglottic fold

The aryepiglottic fold is an important anatomical structure within the larynx, playing a critical role in protecting the airway during swallowing. It forms the upper border of the laryngeal inlet, extending from the lateral aspect of the epiglottis to the arytenoid cartilage on each side. This fold contains ligamentous tissue, muscle fibers, and is covered by mucosa, serving as a key landmark in endoscopy and cross-sectional imaging.

Anatomy and Location

  • The aryepiglottic fold is a paired structure, right and left, forming the lateral margins of the laryngeal inlet.

  • It stretches from the lateral edge of the epiglottis to the apex of the arytenoid cartilage.

  • Forms the superior border of the quadrangular membrane.

Function

  • Acts as a sphincter during swallowing to prevent aspiration.

  • Closes the laryngeal inlet by approximating the arytenoid cartilages and the epiglottis.

  • Important for the cough reflex and protection of the lower airways.

Origin

  • Arises from the lateral edge of the epiglottis.

Insertion

  • Inserts into the apex and anterolateral surface of the arytenoid cartilage.

Nerve Supply

  • Supplied by the internal branch of the superior laryngeal nerve (branch of the vagus nerve, CN X).

  • Provides sensory innervation to the mucosa covering the aryepiglottic fold.

Artery Supply

  • Supplied by branches of the superior laryngeal artery (branch of the superior thyroid artery, from the external carotid artery).

Vein Supply

  • Drains via the superior laryngeal vein into the superior thyroid vein, which subsequently drains into the internal jugular vein.

MRI Appearance

  • T1-weighted images:
    The aryepiglottic fold appears as a low to intermediate signal structure due to its soft tissue and muscular content.

  • T2-weighted images:
    Shows intermediate to mildly hyperintense signal relative to muscle, as the fold contains connective tissue and some fat.

  • STIR (Short Tau Inversion Recovery):
    The fold may appear more hyperintense due to increased water content in the mucosa and connective tissue, helping delineate edema or pathology.

CT Appearance

  • The aryepiglottic fold appears as a soft tissue density extending from the lateral epiglottis to the arytenoid cartilage.

  • Best appreciated on axial and coronal images as the lateral border of the laryngeal inlet.

MRI images

Aryepiglottic fold mri image