The preepiglottic and paraglottic spaces in relation to spread of carcinoma of the larynx.

The submucosal compartments of the larynx were examined using a whole-organ sectioning technique. Seven specimens of normal larynx and 35 specimens of carcinoma of the larynx were studied. Victoria blue and van Gieson stains were used to demonstrate connective tissue elements. The preepiglottic space was distinctly separated from the paraglottic spaces by membranous partitions made up of collagen and elastic fibers. These partitions offer some resistance to tumor invasion in the early stages of laryngeal cancer, keeping the tumor from extending to the adjacent compartment while allowing it to spread freely within the same compartment. In the absence of mucosal extension across the midline, submucosal spread of tumor to the opposite side is unlikely. In view of possible cranial spread of tumor along the preepiglottic and paraglottic spaces, excision of all these spaces, together with the hyoid bone, is indicated in total laryngectomy.