Laryngeal Vestibule

ByA. Mendelson, MD
Please read the disclaimer

The laryngeal vestibule is an important part of the upper airway, located between the entrance of the larynx and the vocal cords. When it appears on a radiology report, it often relates to imaging of the neck or airway, typically from CT, MRI, or specialized swallowing studies. Understanding this structure and why it may be mentioned helps patients make sense of findings on reports.

What Is the Laryngeal Vestibule?

The laryngeal vestibule is the upper portion of the laryngeal cavity. It starts at the laryngeal inlet, where air enters from the pharynx, and ends at the level of the vestibular folds (also called false vocal cords). It forms a gateway that protects the airway from food, liquids, or other substances entering the lungs.

Why the Laryngeal Vestibule Appears on Imaging

Radiology exams such as CT neck, MRI neck, or videofluoroscopic swallowing studies may include the laryngeal vestibule in the field of view. It may be mentioned in reports for:

  • Assessment of swallowing problems

  • Airway evaluation after injury or surgery

  • Cancer detection and staging in the throat or voice box

  • Infection or inflammation that may narrow the airway

  • Trauma from accidents or medical procedures

Normal Imaging Appearance

On CT or MRI, the laryngeal vestibule appears as an air-filled space above the vocal cords, surrounded by soft tissues. In healthy individuals, the space is open and unobstructed, with smooth lining and no masses. In dynamic swallowing studies, contrast material may briefly pass over this region without entering the lower airway.

Abnormal Findings in the Laryngeal Vestibule

1. Narrowing or Obstruction

Swelling, tumors, or scar tissue can narrow the vestibule, making breathing or swallowing difficult. Imaging shows reduced space or irregular tissue filling the opening.

2. Tumors and Masses

Cancers from the supraglottic larynx, epiglottis, or nearby structures may involve the laryngeal vestibule. Radiology helps determine the size, spread, and involvement of lymph nodes, guiding treatment decisions.

3. Inflammation and Infection

Conditions like epiglottitis or supraglottitis can extend into the vestibule, causing swelling that may quickly block the airway. CT and MRI show thickened tissues and reduced air space.

4. Aspiration Findings

In swallowing studies, liquids or food particles entering the laryngeal vestibule without passing through the vocal cords is called penetration. If the material goes below the vocal cords, it is called aspiration. Both findings are important in evaluating patients with swallowing disorders.

Role of Different Imaging Methods

CT Neck

  • Provides detailed cross-sectional views

  • Detects tumors, swelling, and trauma

  • Quick and widely available

MRI Neck

  • Offers excellent soft-tissue detail

  • Useful in tumor characterization and surgical planning

  • Avoids radiation exposure

Videofluoroscopic Swallow Study (VFSS)

  • Real-time X-ray movie of swallowing

  • Shows if food or liquid enters the vestibule

  • Helps guide speech and swallow therapy

Clinical Importance

A clear and healthy laryngeal vestibule allows smooth breathing and safe swallowing. Abnormalities here can signal serious issues, from early cancer to acute airway obstruction. Radiology findings are often used alongside clinical symptoms and physical exam results to guide next steps.

Common Symptoms That May Lead to Imaging

  • Hoarseness or voice changes

  • Difficulty swallowing (dysphagia)

  • Coughing during eating or drinking

  • Shortness of breath or noisy breathing

  • Sensation of a lump in the throat

When to Seek Urgent Care

Sudden swelling or blockage of the laryngeal vestibule can be life-threatening. Symptoms such as severe breathing difficulty, high-pitched wheezing, or inability to swallow saliva require immediate medical attention.

Treatment Depends on the Cause

  • Tumors: Surgery, radiation, or chemotherapy

  • Inflammation: Antibiotics, steroids, airway protection

  • Swallowing disorders: Therapy with speech-language pathologists, diet modifications

  • Trauma: Surgical repair or airway stabilization

Follow-Up and Monitoring

Radiology follow-up may be needed to check:

  • Reduction in swelling after treatment

  • Tumor shrinkage or regrowth

  • Recovery of airway and swallowing function

Key Takeaway

The laryngeal vestibule is a critical part of the airway that protects the lungs during swallowing. When it appears on a radiology report, it often means the radiologist is assessing airway patency, tumor involvement, or swallowing function. Imaging provides important details that guide diagnosis and treatment, helping ensure airway safety.

References:

https://radiopaedia.org/articles/laryngeal-vestibule-1?lang=us

https://www.ncbi.nlm.nih.gov/books/NBK538202/

https://pmc.ncbi.nlm.nih.gov/articles/PMC3624744/

Disclaimer: The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

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