180 The Elastic Tissue of the Human Larynx 



developed that it is difficult to see the finer anastomosing ones. Eeinke's 

 description is most accurate, and he has demonstrated that the elastic 

 fibers of the ligament have a definite structure, relative to their function. 

 His conclusions may be summed up as follows: The elastic fibers of the 

 ligamentum vocale attain their greatest development in planes parallel 

 to constant tension, and at right angles to constant pressure, while the 

 fibers passing obliquely to anastomose with either of the above systems 

 remain atrophic or have disappeared. 



The Anterior Attachments of the Ligamenta Vocalia. 



There is so mucii difference of opinion among anatomists and laryn- 

 gologists concerning the anterior attachment of the ligamentum vocale, 

 that some account of the views held by the different investigators may 

 be expedient. 



C. Mayer ° was the first to describe in the anterior extremity of each 

 ligament a small cartilaginous nodule, which was found by him in man, 

 and some of the higher apes. These nodules are sometimes designated 

 as the " cartilagines sesamoide^ anteriores." (See Fig. 8.) 



Gerhardt " noted in sections made at the level of the insertion of the 

 ligamenta vocalia into the thyroid cartilage a small firm median process, 

 occupying the angle of the thyroid cartilage, which he considered 

 to be formed from its hyaline substance. This median process is pro- 

 longed on each side by yellowish flexible bands into the anterior extremi- 

 ties of the ligamenta vocalia. The yellowish color of the anterior com- 

 missure and its thickening is produced by these processes. The intimacy 

 of the relation between the median process and its lateral prolongations 

 is variable. However, Gerhardt macerated sections many days in water, 

 but was still unable to separate them without the use of a knife. He 

 considered that microscopically there is repeated at the anterior com- 

 missure the same histological structure that Rhciner had previously 

 described for the processus vocalis of the arytenoid cartilage, and sug- 

 gested that this median process, with its lateral prolongations, be known 

 as the processus vocalis of the thyroid cartilage. 



Yerson " notes that the ligamentum vocale is thickened to form a small 

 nodule immediately behind its attachment to the angle of the 

 thyroid cartilage. Upon sectioning this nodule, it is seen to l)e composed 



» Mayer, C: J. F. Meckel's Arch. f. Anat. u. Physiol.; 1826, p. 194. 

 "Gerhardt: Arch. f. path. Anat., etc., Berl., Bd. xix, pp. 436-437. 

 "Verson: Strieker's Handb. der Lehre von den Geweben des Menschen u. 

 der Thiere. Leipzig, 1871, p. 460. 



