Transient connection or origin of the inferior pharyngeal constrictor during fetal development: A study using human fetal sagittal sections.

The inferior pharyngeal constrictor (IPC) originates from the thyroid and cricoid cartilages and inserts to the pharyngeal raphe. In serial sagittal sections of 37 embryos and fetuses at 6-15 weeks (crown rump length 15-115mm), we found (1) the IPC connecting to the sternothyroideus and thyrohyoideus muscles (16 fetuses at 6-11 weeks) or (2) the cricothyroideus muscle (6 fetuses at 12-15 weeks) in addition to the usual cricoid origin. These aberrant connections were most likely to be transient origins of the IPC not from a hard tissue but nearby striated muscles. In four of the latter six specimens, a tendinous band from the IPC inferior end connected to the cricothyroideus muscle to provide a digastric muscle-like appearance. These aberrant connections with nearby muscles seemed to become separated by a growing protrusion of the thyroid cartilage. Therefore, these aberrant origins were, even if developed, most likely to be "corrected" to the adult morphology during midterm or late prenatal period. The aberrant or transient origin of the IPC seemed to result from a discrepancy in growth of the cartilage and muscles. Such a discrepancy in growth seems to resemble the IPC wrapping around the superior cornu of thyroid cartilage. In addition, a final or adult-like morphology was found in two of the present 37 fetal specimens. It seemed to suggest a significant redundancy in growth rate of the laryngeal structures.

Switching of the Laryngeal Cavity From the Respiratory Diverticulum to the Vestibular Recess: A Study Using Serial Sagittal Sections of Human Embryos and Fetuses.

A cecum-like protrusion of the pharynx (the laryngeal cecum or vestibular recess [VR]) develops immediately anterior to the laryngeal part of the respiratory diverticulum. An expansion of the VR has been well described, whereas the fate of the diverticulum is still obscure, although its pharyngeal opening corresponds to the glottis. We observed sagittal sections of 10 embryos (five specimens at 5-6 weeks and another five at 7-8 weeks) and eight fetuses at 25-30 weeks. At 5-6 weeks, a lumen of the laryngeal part of the respiratory diverticulum appeared, and subsequently, the VR opened into the epithelial lamina. Because of this discrete separation, it seemed unlikely that the pharyngeal pouches contributed to the laryngeal epithelium. At 6-7 weeks, the VR exhibited a high boot-shaped lumen with canalization to the diverticular lumen at the level of the cricoid cartilage. Thus, in a midline area between the bilateral arytenoid cartilages, double laryngeal lumina were evident, separated by the thick midline epithelial lamina. At 25-30 weeks, the inferior part of the VR lumen had become enlarged because of the destruction of the epithelial lamina along the arytenoid and corniculate cartilages. In contrast, candidates for the initial diverticular lumen remained as epithelial slits in the anterosuperior side of the transverse arytenoid muscle. Therefore, the final anterior and lateral laryngeal walls seemed to originate from the VR with canalization, in contrast to the part of the posterior wall derived from the initial diverticular wall.

Morphologic evaluation of the fetal recurrent laryngeal nerve and motor units in the thyroarytenoid muscle.

This study is a morphologic description of the recurrent laryngeal nerve (RLN) and of the number and size of motor units (MUs) in the thyroarytenoid (TA) muscle bilaterally of a human fetus aged 25 weeks. A quantitative analysis of RLN and MUs is presented to investigate similarities with equivalent structures in adults. In the fetus used in our study, the morphologic organization of the RLN was similar to that commonly described in the adult RLN. Moreover, as is observed in adult TA, the TA of the analyzed fetus, particularly the right TA, showed MUs typical of muscles with great motor accuracy. These results may be used to increase our knowledge of the features of the voice in adults and newborns.

Development of the rat larynx: a histological study.

OBJECTIVES/HYPOTHESIS: To evaluate and describe the cartilaginous and muscular development of the rat larynx. STUDY DESIGN: Histologic evaluation. METHODS: The larynges of Sprague Dawley rats of embryonic day (E) 13, 15, 17, 19, 21, postnatal day 0, 14, and adult of 250 gm were collected. Four larynges of each age were harvested, cut into 15-µm serial sections, stained with hematoxylin and eosin, and evaluated under light microscopy. Representative digital images were recorded and evaluated at the preglottic (supraglottic in humans), glottic, and postglottic (subglottic in humans) levels. RESULTS: Brachial arches were observed at E13. At E17, immature structures of the larynx, including skeletal muscle, cartilage, and the lumen were identifiable. Chondrification and muscle formation were clearly seen by E19. The muscular and cartilagenous components of the larynx were well established by E21. During the span between birth and adult maturation, the size of the larynx increased from a height of 1.10 mm to 2.90 mm, and from a width of 1.80 mm to 5.40 mm, and from a length of 1.38 mm to 4.77 mm in the stained section. Although developed at E21, the laryngeal structures continued to grow by approximately 30%. CONCLUSION: Rat laryngeal development parallels that in mice and humans. In the rat, at E17 immature structures of the larynx are identifiable, they are well developed at birth and grow by approximately 30% into adulthood. Understanding the chronology and morphology of the embryogenesis of the rat laryngeal musculature is essential and will allow for further evaluation of the embryologic innervation of these muscles.

Embryologic innervation of the rat laryngeal musculature--a model for investigation of recurrent laryngeal nerve reinnervation.

OBJECTIVES/HYPOTHESIS: Optimal management of vocal fold paralysis would entail recurrent laryngeal nerve (RLN) reinnervation resulting in normal vocal fold motion. Unfortunately, RLN reinnervation currently results in a nonfunctional vocal fold due to synkinetic reinnervation. Therapeutic interventions that guide regenerating axons back to the appropriate muscle would prevent synkinesis and restore vocal fold and glottal function. The initial step toward developing these therapies is the elucidation of the embryologic innervation of the larynx. This study aimed to identify the age of occurrence, timing, and pattern of embryologic innervation of the rat larynx, hypothesizing that differences in these parameters exist between distinct laryngeal muscles. STUDY DESIGN: Descriptive anatomic study. METHODS: The larynx of rats aged embryologic day (E) 15, 16, 17, 19, and 21 were harvested and then sectioned. Two rats were used for each age. Sections were colabeled with neuronal class III ß-tubulin polyclonal antibody to identify the presence of axons and alexa 488 conjugate α-bungarotoxin to identify the presence of motor endplates. The age at which axons and motor endplates were first present was noted. The position and pattern of the axons and motor endplates was recorded in relation to each other as well as the musculoskeletal anatomy of the larynx. The time at which axons appeared to innervate the medial thyroarytenoid (MTA) muscle, lateral thyroarytenoid (LTA) muscle, and the posterior cricoarytenoid (PCA) muscle was documented. RESULTS: Findings in the rat suggest the RLN reaches the larynx and begins branching by E15. Axons branch dorsally first and reach the PCA muscle before the other muscles. Branching toward the MTA muscle occurs only after axons have reached the LTA muscle. By E19, RLN axons have been guided to and selected their respective muscles with formation of neuromuscular junctions (NMJs) in the PCA, LTA and MTA muscles, though the formation of NMJs in the MTA muscle was comparatively delayed. CONCLUSIONS: This study describes the embryologic innervation of the rat larynx and suggests that there are distinct differences in the age of occurrence, timing, and pattern of innervation of the PCA, LTA, and MTA muscles of the rat. These findings lay the foundation for studies investigating the role of guidance cues in RLN axon guidance and the utility of these cues in the treatment of RLN injury via the stimulation of functional, nonsynkinetic reinnervation.

Morphology of fetal vocal fold and associated structures.

This study is the first detailed qualitative morphologic description of the vocal fold and its associated structures (false vocal fold, larynx ventricle, epithelium, mucous glands, blood vessels, and vocal ligament) of a human fetus aged 25 weeks. In addition, a quantitative analysis of thyroarytenoid (TA) muscle fiber orientation is presented to investigate similarities with adult TA. Histologic cross sections from the vocal fold and the anterior, middle, and posterior regions of the TA muscle were examined bilaterally, and both qualitative and quantitative analyses show that the vocal fold and most of the associated structures are completely established in the studied sample.

Intrinsic laryngeal muscles are spared from degeneration in the dy3K/dy3K mouse model of congenital muscular dystrophy type 1A.

Deficiency of laminin alpha2 chain leads to a severe form of congenital muscular dystrophy (MDC1A). Here, we analyzed whether the intrinsic laryngeal muscles (ILM) are spared in the dy(3K)/dy(3K) mouse model of complete laminin alpha2 chain absence. No muscle degeneration was evident; expression of various laminin chains was similar to that of limb muscles, and sustained integrin alpha7B expression was noted in laminin alpha2 chain-deficient ILM. We conclude that ILM are spared in MDC1A.

[Functional anatomy of the larynx from clinical viewpoints. Part I: development, laryngeal skeleton, joints, insertion structures, musculature]. / Update Larynx: funktionelle Anatomie unter klinischen Gesichtspunkten. Teil I: Entwicklung, Kehlkopfskelett, Gelenke, Stimmlippenansatz, Muskulatur.

ENT specialist and phoniatricians are not the only professionals for whom diseases of the larynx occupy centre stage; this applies to those in all fields involving conservative or surgical treatment of the larynx, such as speech therapists, paediatricians, anaesthetists, oncologists, pulmonologists, radiologists and general practitioners. On the basis of current knowledge and taking account of results yielded by their own research in recent years and of clinical aspects, in this paper the authors give a short overview of basic knowledge on the anatomy and physiology of the larynx. Part 1 deals with its development and division, the laryngeal skeleton and joints, the insertion structures of the vocal folds and the laryngeal musculature and describes new insights into the mineralization and ossification of the laryngeal skeleton and their implications for phonation, arytenoid subluxation, degenerative joint changes and the biomechanics of vocal cord insertion.

Embryological study of the glottic site and clinical implications.

The development of the glottic site, in particular of its ventral area, was studied to better understand the spreading pathways of T1, T2 cancer. Serial sections of larynges from human embryos, fetuses and adults were observed. A dorsal, a ventral and an intermediate compartment were found on the basis of their maturation schedule. A commissure muscle which develops in the anterior one third of the glottic site and wraps the connection system of vocal ligaments was recognized. The inferior paraglottic space, the compartment structures and the localization of superficial and deep blood vessels and of glands in the ventral compartment and the components of Broyles ligament were studied during ontogenesis. The compartments identified here have clinical and oncological relevance. Their detailed knowledge offers a prerequisite for planning and performing compartment conservative surgery in T1, T2 cancer, based on their spreading pathways.

Myotube heterogeneity in developing chick craniofacial skeletal muscles.

Avian skeletal muscles consist of myotubes that can be categorized according to contraction and fatigue properties, which are based largely on the types of myosins and metabolic enzymes present in the cells. Most mature muscles in the head are mixed, but they display a variety of ratios and distributions of fast and slow muscle cells. We examine the development of all head muscles in chick and quail embryos, using immunohistochemical assays that distinguish between fast and slow myosin heavy chain (MyHC) isoforms. Some muscles exhibit the mature spatial organization from the onset of primary myotube differentiation (e.g., jaw adductor complex). Many other muscles undergo substantial transformation during the transition from primary to secondary myogenesis, becoming mixed after having started as exclusively slow (e.g., oculorotatory, neck muscles) or fast (e.g., mandibular depressor) myotube populations. A few muscles are comprised exclusively of fast myotubes throughout their development and in the adult (e.g., the quail quadratus and pyramidalis muscles, chick stylohyoideus muscles). Most developing quail and chick head muscles exhibit identical fiber type composition; exceptions include the genioglossal (chick: initially slow, quail: mixed), quadratus and pyramidalis (chick: mixed, quail: fast), and stylohyoid (chick: fast, quail: mixed). The great diversity of spatial and temporal scenarios during myogenesis of head muscles exceeds that observed in the limbs and trunk, and these observations, coupled with the results of precursor mapping studies, make it unlikely that a lineage based model, in which individual myoblasts are restricted to fast or slow fates, is in operation. More likely, spatiotemporal patterning of muscle fiber types is coupled with the interactions that direct the movements of muscle precursors and subsequent segregation of individual muscles from common myogenic condensations. In the head, most of these events are facilitated by connective tissue precursors derived from the neural crest. Whether these influences act upon uncommitted, or biased but not restricted, myogenic mesenchymal cells remains to be tested.

TNM glottic: role of the vocal muscle, arytenoid cartilage, and inferior paraglottic space in impaired vocal cord mobility (T2). An embryological and clinical study.

The TNM classification is unsatisfactory regarding the impaired mobility of the vocal cord and/or the arytenoid. The authors have studied the intrinsic laryngeal musculature, with particular attention to the medial thyroarytenoid muscle, the lateral thyroarytenoid muscle, and the inferior paraglottic space. The study was conducted on serial sections of 4 embryonal and 9 fetal larynges at different stages of development. The embryological observations showed that the lateral and medial thyroarytenoid muscles have different maturation times and probably different functions: phonatory and sphincteric. The authors have found that the inferior paraglottic space is situated between these 2 muscles. It would represent a path of diffusion for glottic cancer and play a central role in impaired vocal cord and/or arytenoid mobility, according to the degree of diffusion. Embryological observations have suggested the existence of laryngeal morphofunctional units belonging to the subsites of the glottic region and related to tumoral spreading.

Hormone-sensitive stages in the sexual differentiation of laryngeal muscle fiber number in Xenopus laevis.

The number of muscle fibers in the vocal organ of the adult male African clawed frog, Xenopus laevis, exceeds that of adult females. This sex difference is the result of rapid fiber addition in males between the end of metamorphosis, post-metamorphic stage 0 (PM0) and PM2. At PM0, male and female frogs have similar numbers of laryngeal muscle fibers. Males then add more muscle fibers than females and achieve an adult value that is 1.7 times the female number. Males castrated at PM0 have the same fiber number as females. Ovariectomy at PM0 does not alter muscle fiber addition in females. Gonadectomy at PM2 has no effect on fiber addition in either sex. Females attain masculine muscle fiber number if their ovaries are replaced with a testis at metamorphosis. Exogenous testosterone treatment at PM0 significantly increases fiber number in females but not in males. Exogenous testosterone given at PM2 has no effect on fiber number in females but decreases fiber number in males. We conclude that the testes are necessary for the marked addition of laryngeal muscle fibers seen in male X. laevis between PM0 and PM2. The masculine pattern of muscle fiber addition can be induced in females provided with a testis. Androgen secretion from the testes most probably accounts for masculinization of laryngeal muscle fiber number. After PM2, androgens are no longer necessary for muscle fiber addition and cannot increase fiber number in females.

Androgen-induced myogenesis and chondrogenesis in the larynx of Xenopus laevis.

We investigated a possible role for testosterone-induced cell proliferation in the development of sexual dimorphism in the larynx of South African clawed frogs, Xenopus laevis. Androgen-induced cell proliferation was studied using [3H]thymidine autoradiography. Nuclei of cartilage, perichondrium, and muscle were labeled in the larynx of sexually immature frogs of both sexes but not in adults. Cell proliferation did not occur with estradiol treatment nor was it seen in nonlaryngeal muscle or cartilage. Electron microscopic/autoradiographic studies of laryngeal muscle indicate that testosterone stimulates satellite cell division which later results in formation of myonuclei. We conclude that testosterone induces both chondrogenesis and myogenesis in juvenile larynx and that this process may contribute to the pronounced sexual dimorphism of the adult vocal organ.

Neuromuscular junctions of the posterior cricoarytenoid muscle in the human adult, human fetus and cat. Histochemical and electron microscopic study.

The motor end plate of the posterior cricoarytenoid muscle (PCA muscle) in the human adult, human fetus and cat was examined by using electron microscopy and histochemical methods. In the present study, we observed the single-type motor end plate and en plaque type neuromuscular junction. At the neuromuscular junction of the fetal PCA muscle, the primary synaptic cleft, the basement membrane and the postsynaptic density could already be observed; however, there was no secondary synaptic cleft. Histochemically, the subneural apparatus was filled with electron-dense products, indicating acetylcholinesterase (AChE) activity. The primary and secondary synaptic clefts in the adult PCA muscle were well developed and intense AChE activity was present. The appearance of the neuromuscular junction and its localization of AChE activity was similar to that in the cat PCA muscle.

The embryonic origins of avian cephalic and cervical muscles and associated connective tissues.

The objective of these experiments was to determine the embryonic origins of craniofacial and cervical voluntary muscles and associated connective tissues in the chick. To accomplish this, suspected primordia, including somitomeres 3-7, somites 1-7, and cephalic neural crest primordia have been transplanted from quail into chick embryos. Quail cells can be detected by the presence of a species-specific nuclear marker. The results are summarized as follows: (table; see text) These results indicate that muscles associated with branchial arch skeletal structures are derived from paraxial mesoderm, as are all other voluntary muscles in the vertebrate embryo. Thus, theories of vertebrate ontogeny and phylogeny based in part on proposed unique features of branchiomeric muscles must be critically reappraised. In addition, many of these cephalic muscles are composites of two separate primordia: the myogenic stem cells of mesodermal origin and the supporting and connective tissues derived from the neural crest or lateral plate mesoderm. Defining these embryonic origins is a necessary prerequisite to understanding how the mesenchymal primordia of cephalic muscles and connective tissues interact to form patterned, species-unique musculoskeletal systems.