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Laryngeal vestibule

The laryngeal vestibule is the superior portion of the larynx, extending from the laryngeal inlet to the vestibular folds (false vocal cords). It functions as a protective entryway to the lower airway, preventing aspiration during swallowing. Accurate understanding of its anatomy, function, and imaging appearance is essential for radiologists, ENT specialists, and surgeons, particularly when assessing tumors, inflammation, or congenital anomalies.

Synonyms

  • Supraglottic laryngeal space

  • Laryngeal inlet region

  • False vocal cord region

  • Vestibular portion of the larynx

Function

  • Protects the lower airway by guiding food and liquid away from the trachea

  • Houses the vestibular folds which contribute to airway protection and resonance

  • Plays a role in preventing aspiration during swallowing

  • Participates in phonation as part of the supraglottic mechanism

MRI Appearance

 

T1-weighted images:

  • The laryngeal vestibule is filled with air, which appears as a signal void (black).

  • The surrounding soft tissues (vestibular folds, aryepiglottic folds, and paralaryngeal muscles) show intermediate signal intensity, slightly darker than fat.

  • Paralaryngeal fat is hyperintense, providing natural contrast to the vestibule walls.

  • Pathological lesions, such as tumors or edema, appear hypo- to isointense relative to muscle and may enhance with contrast.

T2-weighted images:

  • Air remains signal void (black), creating a sharp outline of the vestibule.

  • Mucosa, soft tissue, and edema appear intermediate to high signal, making inflammatory or neoplastic changes more conspicuous.

  • Surrounding fat appears hyperintense, helping define the vestibular boundaries.

STIR (Short Tau Inversion Recovery):

  • Fat suppression removes signal from paralaryngeal fat, allowing clear visualization of edema or tumors.

  • Air remains a signal void, while abnormal tissue (edema, inflammation, tumor) appears bright hyperintense, highlighting pathology.

  • This sequence is particularly useful for detecting subtle inflammatory or neoplastic changes in the vestibule and supraglottic larynx.

CT Appearance – Laryngeal Vestibule

  • On non-contrast CT, the laryngeal vestibule is easily identified as an air-filled space, appearing hypodense (black) relative to surrounding soft tissues.

  • The walls of the vestibule, including the vestibular folds (false vocal cords), aryepiglottic folds, and thyroid cartilage, are soft tissue density and clearly delineated against the air.

  • Cartilaginous structures (thyroid, arytenoid, and epiglottis) appear intermediate density, while any ossification or calcification is hyperdense.

  • CT is particularly useful for assessing airway patency, fractures, cartilage invasion by tumors, and calcifications.

MRI images

Laryngeal vestibule mri image-img-00000-00000