Greater Cornu of the Thyroid Cartilage

cornu superius cartilaginis thyroideae

The greater (superior) cornu of the thyroid cartilage is a long backward-projecting horn from the posterior superior edge of each thyroid lamina, connected to the greater horn of the hyoid bone by the lateral thyrohyoid ligament. The superior laryngeal artery and internal laryngeal nerve pierce the thyrohyoid membrane just superior to the greater cornu tip. The inferior cornu (lesser horn) articulates with the cricoid at the cricothyroid joint.

Region: Neck

Clinical Relevance

Clinical Notes

The greater cornu of the thyroid cartilage is the landmark for superior laryngeal nerve block, used to anaesthetise the larynx above the vocal cords for awake intubation. The internal laryngeal nerve is blocked by injecting local anaesthetic just below the tip of the greater cornu where the nerve pierces the thyrohyoid membrane. The greater cornu tip is also palpable as a posterior landmark in neck dissection for identifying the carotid sheath contents. Ossification of the thyroid cartilage with age can simulate pathological calcification on radiograph.

Pathology

Common Injuries & Conditions

Superior Laryngeal Nerve Block at Greater Cornu

Local anaesthetic injection just inferior to the tip of the thyroid cartilage greater cornu, where the internal laryngeal nerve pierces the thyrohyoid membrane, provides unilateral supraglottic anaesthesia for awake flexible laryngoscopy and awake fibreoptic intubation; bilateral blocks combine with transtracheal injection to produce complete airway anaesthesia.