Configuration of elastin fibers in the intra- and extra-capsule ligaments of the elderly cricoarytenoid joint

PURPOSE: To define the localization and configuration of the elastic fibers of the cricoarytenoid ligament (CAL) and their relationship with the cricoarytenoid joint (CAJ) capsule. METHODS: Twenty-four CAJs from twelve cadavers were analyzed using Verhoeff-Van Gieson staining, and immunohistochemistry methods. This is a prospective study. RESULTS: The CAL was classified into two parts: an extra-capsular anterior-CAL and an intra-capsular posterior-CAL. The both parts contained rich elastic fibers. The elastic fibers of the anterior-CAL were orientated in both anterior–posterior and superior–inferior directions and under a relaxation status, whereas the elastic fibers of the posterior-CAL were arranged in a lateral–medial direction and under a taut status. CONCLUSIONS: This study defined the fine configuration of the CAL, particularly its elastic fibers, which may help us to better understand the biomechanics of the CAJ motions, and differential diagnosis of CAJ disorders. The results of the study re-confirm that the P-CAL is the key posterior–lateral passive force to limit the mobility of the muscular process of the arytenoid cartilage and stabilize the CAJ, whereas the A-CAL may protect the CAJ from an over superior–lateral–posterior motion. Level of evidence: H/A.