Paraglottic Space

spatium paraglotticum

The paraglottic space is the bilateral fat-filled space within the larynx between the laryngeal ventricle (medially), the thyroid cartilage (laterally), the conus elasticus (inferiorly), and the quadrangular membrane (superiorly). It directly communicates with the pre-epiglottic space anteriorly. Laryngeal carcinoma invading the paraglottic space can spread transglottically to involve both supraglottic and glottic levels simultaneously.

Region: Neck

Clinical Relevance

Clinical Notes

Paraglottic space invasion by laryngeal carcinoma represents transglottic spread, indicating a T3 minimum staging and often requiring total laryngectomy since the cartilage and space are difficult to clear with partial resection. CT and MRI identify fat replacement in the paraglottic space by tumour signal. The recurrent laryngeal nerve runs in the tracheoesophageal groove but enters the larynx adjacent to the inferior paraglottic space. Transoral robotic surgery (TORS) for supraglottic carcinoma aims to stay outside the paraglottic space.

Pathology

Common Injuries & Conditions

Transglottic Laryngeal Cancer Invading Paraglottic Space

Laryngeal carcinoma crossing from supraglottic to glottic levels via the paraglottic space produces transglottic disease with vocal cord fixation from thyroarytenoid involvement; CT demonstrating paraglottic space fat obliteration with cord fixation (T3 disease) indicates the need for total laryngectomy with voice prosthesis rehabilitation.