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Purpose: Precise knowledge of the level of the vocal fold as projected on the external thyroid cartilage is of critical importance for the performance of many surgical approaches. This study aims to identify the level of the anterior commissure, as well as the lengths of the vocal muscle and arytenoid cartilage in Turkish population. Materials and Method: Specimens were collected after autopsy from the Council of Forensic Medicine. One hundred human larynges (52 men, 48 women; age range: 25-80 years) were dissected under a stereomicroscope. Projection of the vocal fold was analyzed in relation to the superior thyroid (A) and the inferior border of the thyroid cartilage (B). Then, the larynx was dissected parallel to the level of the vocal fold to measure the length of the vocal muscle (C) and the length of the interarytenoid space (D). Results: The mean value of the “a” was 9.15 ± 1.99 mm in male and 9.38 ± 3.43 mm in female. Mean value of the “b” was 10.54 ± 1.73 mm and 8.88 ± 1.81 mm in male and female, respectively. The mean value of the parameter corresponding the length of vocal muscle which was “c” was found 15.00 ± 3.18 mm in male and 12.88 ± 4.12 mm in female. The mean value of the interarytenoid space “d” was 8.31 ± 1.76 mm in male and 8.13 ± 1.90 mm in female. Comparing between genders, no statistical differences were observed in parameters of a, c, d, a + b, a + b/2 ( P > .05). However, the difference with female and male for the parameters of b and c + d was statistically significant ( P < .05). Conclusion: Our results indicate that the anterior commissure projects slightly above the midline height for male and at the level to slightly below in female subjects in Turkish population.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior The great motivation to the development of this research was justified for the necessity to define which the rigid endoscope used in surgeries of endolarynx that it possessed the best capacity of show this anatomical region, thus being searchs to create a methodology in which could demonstrate this idea. The rigid endoscopy of endolarynx, idealized in 1994 by Mário Andréa and Oscar Dias, is defined with semiotic method of enormous value in analyzes of the structures of this anatomical region and is used of four endoscopies with angle varied of 0°, 30°, 70° and 120°. We take as base the "Anatomical Areas of D'Avila" (D'Avila, 2003), endorsed in statistics of Fischer Exact Test and study of the descriptive retrospective type, we compare the images of 30 surgeries carried through in carrying patients of carried through illnesses varied of endolarynx in the period of July of 2005 the April of 2006. The elements of the set had been examined and operated in the Otocenter clinic and Hospital São Lucas (Aracaju-Sergipe) respectively. The age varied of 13 the 78 years, with 44,6 average of and medium of 45,5 years. We sequentially analyze endolarynx the 02 cm and the 01 upglottis cm, to the glottis level and the 01 subglottis cm, being the endoscopies located in position straight line and oblique line 45° for the right and the left and always above juxtaposed to the traqueal pipe. In all the distances and angle proposals were established the number of visualized areas (Anatomical Areas of D'Avila) being soon after carried through rigorous addition of related areas definite as numbers one, two and three. Thus, we define in percentile terms which the sequence of endoscopies with better visual performance, which in the distance with bigger number of show areas and which the position (straight line or oblique line) more including for the studied areas. We conclude to be the endoscope of 30° that one with the best global expositive capacity (35%), followed of the endoscope of 0° (29%), 70° (27%) and 120° with only 9% of show capacity. In the moving one at a distance, it was the 01 upglottis cm that if established the biggest number of areas observed (88 times) in relation to the too much searched distances. The oblique position (54%) if detached in expositive capacity in relation to the position straight line (46%). The compare with world-wide literature was not possible since it is about unknown study. A grande motivação ao desenvolvimento desta pesquisa se justificou pela necessidade de definirmos qual o endoscópio rígido utilizado em cirurgias da endolaringe que possuísse a melhor capacidade de exposição desta região anatômica. Assim sendo, buscamos criar uma metodologia na qual pudéssemos demonstrar cientificamente esta idéia. A endoscopia rígida da endolaringe, idealizada em 1994 por Mário Andréa e Oscar Dias, é definida com método semiótico de enorme valor na analise das estruturas desta região anatômica e utiliza-se de quatro endoscópios com angulações variadas de 0°, 30°, 70° e 120°. Tomamos como base as regiões anatômicas denominadas de Áreas Anatômicas de D Avila (D Avila, 2003), respaldados estatisticamente no Teste Exato de Fischer e em estudo do tipo retrospectivo descritivo, comparamos as imagens de 30 cirurgias realizadas em pacientes portadores de doenças variadas da endolaringe realizadas no período de Julho de 2005 a Abril de 2006. Os elementos do conjunto foram examinados e operados na clínica Otocenter e Hospital São Lucas (Aracaju-Sergipe) respectivamente. A idade dos pacientes operados variou de 13 a 78 anos, com média de 44,6 e mediana de 45,5 anos. Analisamos sequencialmente a endolaringe a 02 cm e a 01 cm supraglótico, ao nível glótico e a 01 cm subglótico, sendo os endoscópios posicionados sistematicamente em posição reta e oblíqua a 45° para a direita e para a esquerda sempre acima e justapostos ao tubo orotraqueal. Em todas as distâncias e angulações propostas foi estabelecido o número de áreas observadas (Áreas Anatômicas de D Avila) sendo logo após realizado rigoroso somatório das referidas áreas definidas como números um, dois e três. Assim, definimos em termos percentuais qual a seqüência de endoscópios com melhor desempenho observacional, qual a distância com maior número de áreas visualizadas e qual a posição (reta ou oblíqua) mais abrangente para as áreas estudadas. Concluímos ser o endoscópio de 30° aquele com a melhor capacidade de exposição global (35%), seguido dos endoscópios de 0° (29%), 70° (27%) e 120° com 9% apenas de capacidade de exposição. No tocante à distância, foi a 01 cm supraglótico que se estabeleceu o maior número de áreas observadas (88 vezes) em relação às demais distâncias pesquisadas. A posição oblíqua (54%) se destacou em capacidade de exposição em relação à posição reta (46%). Não foi possível o pareamento com a literatura mundial visto que se trata de estudo inédito.