正中舌喉頭蓋皺襞の形態と臨床的意義—佐藤教授開講週年記念論文

1）喉頭像を生体で見る場合，最も使利なのは喉頭鏡檢査であり，特別の場合に直達鏡檢査が用いられる．喉頭鏡檢査を妨げる因子として，鋭敏な反射作用，喉頭の形態就中喉頭蓋の傾斜と形態が問題になる．喉頭蓋に覆われ内景が何としても見られず，ルブリンスキー氏喉頭蓋起子を用いても尚お失敗することがある．舌を引き出すと，自ら喉頭蓋が前方え引き起されるが，此の場合正中舌喉頭蓋皺襞が相当な役割をしていると考えられる．

　2）喉頭異物中で，喉題蓋谷特にの中央の舌根と喉頭蓋前壁の間に於けるものは往々にして檢出洩れとなり易い，特に間腔の狹い場合が問題となる，之も正中舌喉頭蓋皺襞の張りの強さが相当物を言う．

Iinuma says a careful study of median glosso-epiglottic fold which brings the tongue and the epiglottis in a close tie with each other reveals numerous points characteristically anologous to those of the frenulum. Morphologically the structure may be divided into 5 distinct types and the criterion for such differentiation depends upon its inherent properties of length, elasticity and expansibility. The first or normal type, the three components are within normal limits; the second type, elasticity and expansibility alone are well developed; the third type, all three components are poorly developed; the fourth type, the length alone is limited but two othercomponents are well developed; and, the fifth type, the length is extremely limited but elas-ticity and expansibility are unduely well developed. What is most remarkable about this last type is that it closely resembles a foreshortened frenulum.

In presence of these morphological abnormali-ties in the median glosso-epiglottic fold indirect laryngeal examinations espaecially, would be rendered as a matter of great difficulty; foreign bodies easily find a place of lodgement because of the retreat thereby provided for; symptoms which might arise from hypertrophied lingual tonsils would be unduely exentuated; and, any operative procedure that might be necessary at the root of the tongue would be also rendered as a matter of difficulty.