The median cricothyroid ligament (cricothyroid membrane) is the fibro-elastic membrane connecting the lower border of the thyroid cartilage to the upper border of the cricoid cartilage in the anterior midline. It is the thickest and most accessible part of the cricothyroid membrane, the primary site for emergency surgical airway access.
Connects the thyroid and cricoid cartilages in the anterior larynx; its inferior conus elasticus portion maintains vocal cord tension; the superior portion is the emergency airway access site.
The median cricothyroid ligament is the target for cricothyrotomy in cannot-intubate-cannot-oxygenate emergencies. It is palpable as a soft spot between the thyroid and cricoid cartilages in the anterior midline. A horizontal stab incision through the ligament provides immediate airway access. Scalpel-bougie-tube technique is the current recommended surgical airway approach. Needle cricothyrotomy through this ligament provides temporary oxygenation while a definitive airway is established.
Subglottic stenosis at the cricothyroid ligament incision site following prolonged cricothyrotomy or tracheostomy conversion, producing progressive dyspnoea and voice change requiring endoscopic or open reconstruction.
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