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Vestibular fold & vestibular ligament

The vestibular folds, also known as false vocal cords, are paired mucosal folds in the supraglottic larynx. The vestibular ligament forms their core, stretching from the thyroid cartilage to the arytenoid cartilage. Together, they form the upper boundary of the laryngeal vestibule and play a critical role in airway protection during swallowing. Knowledge of their anatomy, function, and imaging characteristics is essential for radiologists, ENT specialists, and surgeons, particularly when evaluating laryngeal tumors, edema, or congenital anomalies.

Synonyms

  • False vocal cords

  • Supraglottic folds

  • Vestibular ligaments

  • Upper laryngeal folds

Function

  • Protect the lower airway by closing the laryngeal inlet during swallowing

  • Contribute to airway resistance and voice resonance

  • Support the vestibule and guide airflow into the glottis

  • Assist in preventing aspiration

MRI Appearance

T1-weighted images:

  • The vestibular folds appear as linear soft tissue structures of intermediate signal along the lateral walls of the laryngeal vestibule

  • Surrounded by hypointense air (signal void) in the lumen and hyperintense paralaryngeal fat, which provides contrast

  • Pathological lesions (tumor, edema) may appear hypo- to isointense and enhance with contrast

T2-weighted images:

  • The vestibular folds show intermediate signal, while air remains signal void (black)

  • Edema, cysts, or inflammation appear hyperintense, making pathological changes easily detectable

  • Surrounding paralaryngeal fat is hyperintense, highlighting soft tissue boundaries

STIR (Short Tau Inversion Recovery):

  • Fat suppression highlights inflammatory or neoplastic changes

  • Normal vestibular folds remain low signal; edema, tumor, or inflammation appears bright hyperintense

  • Air remains signal void, providing clear anatomical contrast

CT Appearance

  • The vestibular folds and ligaments appear as soft tissue density structures along the lateral walls of the air-filled laryngeal vestibule

  • The air within the vestibule appears hypodense (black), outlining the folds

  • Cartilaginous attachments (thyroid and arytenoid cartilages) appear intermediate density, with calcification if present appearing hyperdense

  • Pathologies such as tumors, mucosal thickening, or edema are visible as areas of soft tissue density within the normally air-filled space

  • CT is useful for evaluating airway patency, cartilage invasion, or laryngeal masses

MRI images

Vestibular fold & vestibular ligament mri sag image -img-00000-00000