Corniculate and Cuneiform Cartilages

cartilagines corniculatae et cuneiformes

The corniculate cartilages (Santorini cartilages) are small paired nodules of elastic cartilage sitting atop the arytenoid cartilages, extending the vocal process apex and stabilising the aryepiglottic fold. The cuneiform cartilages (Wrisberg cartilages) are elongated paired elastic cartilage rods embedded in the aryepiglottic folds anterior to the corniculata, creating visible longitudinal ridges (cuneiform tubercles) seen on laryngoscopy.

Region: Neck

Clinical Relevance

Clinical Notes

The corniculate and cuneiform tubercles are the first landmarks visible on direct and video laryngoscopy, guiding the laryngoscopist to the correct structures. In difficult airway situations, identifying the corniculate tubercles posteriorly orients the practitioner to the laryngeal inlet. Aryepiglottic fold tumours (supraglottic cancer) involve these cartilages and are managed by partial laryngectomy or transoral robotic surgery. The prominent corniculate tubercles may be mistaken for pathological lesions by inexperienced endoscopists.

Pathology

Common Injuries & Conditions

Corniculate Tubercle as Airway Landmark in Difficult Intubation

The corniculate tubercles sitting atop the arytenoids are the primary posterior landmarks visible when the epiglottis obstructs direct glottic visualisation; identifying these posterior structures and directing the tube anteriorly toward the space between them guides successful intubation even with a Cormack-Lehane Grade 3 view.