Which statement about the anterior commissure tendon (Broyles ligament) is correct?
- A It is a richly vascularised structure that promotes lymphatic spread across the midline
- B It connects the epiglottis to the hyoid bone and forms the roof of the pre-epiglottic space
- C It anchors the vocal ligaments to the inner aspect of the thyroid cartilage and is relatively devoid of blood vessels and lymphatics ✓
- D It suspends the arytenoid cartilages from the cricoid lamina posteriorly
Correct answer: C. It anchors the vocal ligaments to the inner aspect of the thyroid cartilage and is relatively devoid of blood vessels and lymphatics
Explanation
Broyles ligament is the anterior commissure tendon anchoring both vocal ligaments to the inner thyroid lamina at the Broyles angle. It is largely avascular and lacks lymphatics, acting as a relative barrier to spread. However, a tumour reaching this attachment gains direct access to the thyroid cartilage perichondrium, so anterior commissure involvement raises concern for cartilage invasion, which upstages disease to T4a when it extends beyond the inner cortex.
Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.