Laryngeal Anatomy and Morphometry: Foundations for Interdisciplinary Collaboration and Personalized Management of Laryngeal Pathology.
Authors
Affiliations (7)
Affiliations (7)
- ENT Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
- Imaging Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
- ENT Department, Elias Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 011461 Bucharest, Romania.
- ENT Department, Grigore Alexandrescu Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 011743 Bucharest, Romania.
- Anatomy Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Abstract
Laryngeal pathology requires individualized management because the larynx integrates airway protection, phonation, swallowing, and respiratory function within a compact and highly variable anatomical framework. This narrative review examines how laryngeal anatomy and morphometry support interdisciplinary collaboration and personalized care in oncologic, stenotic, functional, and reconstructive laryngeal disease. Evidence from morphometric studies, CT, MRI, endoscopy, ultrasonography, three-dimensional reconstruction, artificial intelligence, and multidisciplinary clinical workflows was synthesized qualitatively. Key parameters-including vocal fold length, glottic width, thyroid cartilage angle, cricoid diameter, subglottic diameter, anterior commissure thickness, and the status of paraglottic and pre-epiglottic spaces-provide actionable information for diagnosis, T-staging, airway assessment, surgical planning, reconstruction, and functional rehabilitation. Morphometry concretely informs clinical decisions: thyroid cartilage angle guides thyroplasty and phonosurgical planning; subglottic diameter supports stenosis surgery and airway instrumentation; and anterior commissure, conus elasticus, cartilage, and deep-space measurements refine oncologic staging and margin strategy. Technological accelerators, including AI segmentation, radiomics, 3D printing, photogrammetry, and ultrasonography, extend morphometry from static measurement toward predictive modeling and patient-specific simulation. However, implementation remains limited by heterogeneous CT protocols, inconsistent measurement planes, uneven access to advanced technologies, lack of global normative databases, and unresolved ethical issues surrounding AI validation and data governance. This review supports standardizing CT morphometry using parallel vocal fold planes, routinely measuring anterior commissure thickness in T1 glottic cancer, incorporating ultrasonography as a first-line morphometric tool in voice clinics, and validating AI segmentation against population-specific morphometric norms. Laryngeal morphometry should therefore become a routine decision-making framework for precision laryngology.