Head and Neck ImagingParaglottic space
the lateral part of the deep laryngeal tissue plane (between the laryngeal framework and the
mucosa). The paired paraglottic spaces are lateral to the
pre epiglottic space. At the level of the glottis, the paraglottic space is limited to a narrow band of fatty tissue lateral to the thyroarytenoid musle, continuous with the supraglottic submucosal fat. This deep fat plane at the level of the true vocal cord continues inferiorly as a thin infraglottic fat plane, bordered by the conus elasticus.
The line of resection in a supraglottic laryngectomy goes through the laryngeal ventricles, between the true and false vocal cords. If a supraglottic cancer spreads inferiorly along the ventricle, in the paraglottic space at the level of the true vocal cord, then speech conservation surgery will not be possible. Tumour extension along the paraglottic spaces may be subtle and clinically occult. Cross-sectional imaging is important in determining the precise caudal extension in such cases. This may be done by either CT or MRI (supraglottic cancer (VI:2), Fig. 2). The direct coronal images obtained with MRI may enhance the radiologist's confidence in determining the exact tumour extension in borderline cases.
RH