[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Vocal folds [Respiratory system](https://durgical.com/en/anatomy/system/respiratory-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Vocal folds The vocal folds (vocal cords) are two bands of muscle and ligament across the larynx; they vibrate to make the voice and close to protect the airway. Official name: Vocal fold [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=vocal_folds&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Two bands of muscle and ligament stretched across the larynx from front to back. ## What it does Vibrate to make the voice and close to protect the airway. ## Key points - Layers: epithelium, a loose superficial lamina propria (Reinke space), the vocal ligament and the vocalis muscle; the loose cover glides over the body to make the mucosal wave - Glottic cancer causes hoarseness early and the true folds have few lymphatics, so early tumours rarely reach the nodes and have a good prognosis - Nodules are bilateral, at the junction of the front and middle thirds, from voice overuse; polyps are usually one-sided - The glottis (folds plus the gap between them, the rima glottidis) is classically taught as the narrowest part of the adult larynx ## Key facts **Attaches** Inner angle of the thyroid cartilage to the vocal processes of the arytenoids **Function** Produce voice; close the airway (cough, effort) **Tight in** [Cricothyroid](https://durgical.com/en/anatomy/oblique-part-of-cricothyroid-muscle/) contraction (high pitch) ## Relations **Above** Laryngeal ventricle, then the vestibular (false) folds **Below** Conus elasticus and the subglottic space, down to the [cricoid cartilage](https://durgical.com/en/anatomy/cricoid-cartilage/) **Lateral** [Thyroarytenoid](https://durgical.com/en/anatomy/musculus-thyreoarytenoideus/) muscle, paraglottic space and the [thyroid cartilage](https://durgical.com/en/anatomy/thyroid-cartilage/) lamina **In front** [Anterior commissure](https://durgical.com/en/anatomy/anterior-commissure/), where the two folds meet behind the thyroid cartilage **Behind** Vocal processes of the [arytenoid cartilages](https://durgical.com/en/anatomy/arytenoid-cartilage/) and the interarytenoid region (posterior commissure) ## How to find it Seen with a laryngeal mirror, a flexible nasal endoscope or a rigid endoscope as two pearly white bands in a V with the point in front; they open on breathing in and meet on a sustained vowel. Stroboscopy shows the mucosal wave. ## On imaging Laryngoscopy with stroboscopy is the main examination. CT and MRI stage cancer by looking at the paraglottic space, the anterior commissure and the laryngeal cartilages. ## Common problems - Laryngitis and overuse: hoarseness. - Nodules and polyps from voice strain (singers, teachers). - Paralysis from [recurrent laryngeal nerve](https://durgical.com/en/anatomy/recurrent-laryngeal-nerve/) injury. - Hoarseness for more than 3 weeks, especially in smokers, needs a check for cancer. ## How it is diagnosed Laryngoscopy (a camera to look at the vocal folds). ## Treatment - Voice rest and voice therapy. - Microsurgery for polyps; treatment of cancer by surgery or radiotherapy. ## Clinical notes - Reinke oedema: smoking-related swelling of the superficial lamina propria, giving a low, husky voice - Recurrent respiratory papillomatosis: HPV-related warty growths (mainly types 6 and 11) in children and adults, which tend to come back - Vocal fold dysfunction (the folds close on breathing in) can mimic asthma ## Development The laryngeal lumen closes and then reopens in the embryo; incomplete reopening leaves a laryngeal web, usually across the front of the glottis. ## Related conditions - [Farber disease (Farber lipogranulomatosis)](https://durgical.com/en/conditions/farber-disease/) - [Laryngeal cancer](https://durgical.com/en/conditions/laryngeal-cancer/) - [Anaphylaxis](https://durgical.com/en/conditions/anaphylaxis/) - [Botulism](https://durgical.com/en/conditions/botulism/) - [Vocal fold nodules, polyps and laryngitis](https://durgical.com/en/conditions/vocal-fold-nodules-polyps-and-laryngitis/) - [Vocal fold paralysis (recurrent laryngeal nerve injury)](https://durgical.com/en/conditions/vocal-fold-paralysis/) - [Croup (laryngotracheobronchitis)](https://durgical.com/en/conditions/croup/) - [Cri-du-chat syndrome (5p deletion)](https://durgical.com/en/conditions/cri-du-chat-syndrome/) ## Test yourself Think of the answer, then tap the question to see it. ## What are the layers of the vocal fold, and which one produces the mucosal wave? Epithelium, superficial lamina propria (Reinke space), vocal ligament and vocalis muscle; the loose superficial cover glides over the body to make the mucosal wave. ## Why does early glottic cancer have a good prognosis? It causes hoarseness early, and the true vocal folds have few lymphatics, so early tumours rarely reach the neck nodes. ## Where do vocal fold nodules form and how do they differ from polyps? Bilaterally at the junction of the front and middle thirds, from voice overuse; polyps are usually one-sided. ## Which muscle tenses the vocal folds to raise pitch? The cricothyroid, which tilts the thyroid cartilage forward and lengthens the folds. ## What is Reinke oedema? Smoking-related swelling of the superficial lamina propria (Reinke space) of the vocal folds, giving a low, husky voice. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/vocal-fold/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** plica vocalis TA2 3198 **Official Spanish (DeCS)** Pliegues Vocales DeCS D014827 **English (TA2)** Vocal fold **Also called** vocal cords · labium vocale ## Related - [Arytenoid cartilages](https://durgical.com/en/anatomy/arytenoid-cartilage/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=15228); [Anatomy, Head and Neck, Larynx Vocal Cords](https://www.ncbi.nlm.nih.gov/books/NBK535342/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/vocal-fold/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/vocal-fold/