During a total laryngectomy for advanced laryngeal carcinoma, the surgeon identifies the pre-epiglottic space. What structures bound this space?

• A Anteriorly by the cricothyroid membrane, posteriorly by the posterior epiglottis
• B Bounded by aryepiglottic folds laterally and epiglottis posteriorly
• C Bounded by the hyoid bone and thyrohyoid membrane only
• D Anteriorly by the thyroid cartilage and thyrohyoid membrane, posteriorly by the anterior epiglottis, superiorly by the hyoepiglottic ligament ✓

Explanation

The pre-epiglottic space (space of Boyer) is bounded: anteriorly by the thyroid cartilage and thyrohyoid membrane, posteriorly by the anterior surface of the epiglottis and thyroepiglottic ligament, and superiorly by the hyoepiglottic ligament. It contains fat and lymphatics, making it a route for local spread of supraglottic carcinoma. Tumour involving the pre-epiglottic space upstages the lesion and affects surgical planning.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.