Corniculate cartilage

At a glance

English

Corniculate cartilage

Latin (TA2)

Cartilago corniculata

System

Cartilage

Region

Neck

Side

Paired, left and right

About the corniculate cartilage

The corniculate cartilages are a pair of very small conical nodules at the back of the larynx. Each sits on the apex of an arytenoid cartilage and continues its curve, extending it backwards and towards the midline. The name means 'little horn'. They are sometimes called the cartilages of Santorini. In some people a corniculate cartilage is fused to its arytenoid rather than forming a separate piece, joined to it only by a small fibrous or synovial connection.

Unlike the arytenoids, thyroid and cricoid cartilages, which are hyaline, the corniculates are made of elastic cartilage, like the epiglottis and the cuneiform cartilages. This means they stay flexible and do not calcify with age. Each lies within the posterior part of an aryepiglottic fold, the mucous fold that runs from the side of the epiglottis back to the arytenoid. Under the mucosa it raises a small bump, the corniculate tubercle, which can be seen at laryngoscopy at the back of the laryngeal inlet, just behind and below the cuneiform tubercle.

The two corniculate tubercles lie on either side of the interarytenoid notch, the shallow gap at the back of the inlet between the two arytenoids. When the airway closes during swallowing, the arytenoids tip forwards and the aryepiglottic folds tighten, and the corniculates help stiffen the back of the folds so that the inlet is narrowed and sealed. They also give a point of attachment to the aryepiglottic muscle fibres and to the upper part of the cricopharyngeal (corniculopharyngeal) ligament, which ties them to the cricoid behind.

Because the corniculate tubercles are reliable landmarks at the back of the glottis, anaesthetists use them when passing a breathing tube: the tube must go in front of them, between the vocal folds, rather than behind into the oesophagus. Swelling of the mucosa over them is a sign of inflammation or reflux in the back of the larynx.

Attachments and function

Attaches from

Its base sits on the apex of the arytenoid cartilage, joined to it by a small fibrous or synovial connection, or fused with it.

Attaches to

Its tip extends backwards and medially into the posterior part of the aryepiglottic fold, where it is tethered by the corniculopharyngeal ligament.

Function

Prolongs the arytenoid apex, stiffens the back of the aryepiglottic fold and helps shape and close the laryngeal inlet during swallowing.

Nerve supply

The overlying mucosa is supplied by the internal laryngeal branch of the superior laryngeal nerve.

Blood supply

Branches of the superior laryngeal artery supply the surrounding mucosa and perichondrium.