Anterior Commissure

The point at which the vocal cords are joined together, which is at the most anterior end of each cord. Compare this with the posterior commissure.

Photos of the Anterior Commissure:

Capillary Ectasia with Vocal Nodules

Capillary ectasia with vocal nodules (1 of 2)

Breathing position, note insignificant microweb at anterior commissure.

Capillary ectasia with vocal nodules (2 of 2)

Phonatory position, with poor match of vocal margins.

Subtle Papillomas and the Importance of A Motivated Examination

Standard light, HPV-6 infection (1 of 4)

Breathing position, standard light in a young woman with longstanding HPV-6 infection. Voice remains quite good, many months after her last microsurgery with cidofovir injection. The only obvious “lesion” is posterior right cord (left of image) but the characteristic punctate vascular marks are not seen. The black lines are purely for use to orient photo 4.

Stobe light, vocal cord margin irregularity (2 of 4)

With such a clear voice, this prephonatory instant under strobe light reveals a surprising degree of vocal cord margin “serpentine” irregularity. Black lines again support orientation with photo 4.

Narrow band light, vascular marks seen (3 of 4)

At very close range and also using narrow band light, the tiny punctate vascular marks are seen in the lesion first seen in photo 1. Faint vascularity like that demonstrated here can be a correlate of relatively stable, inactive disease, which has clinically been the case here.

Narrow band light, papilloma formation (4 of 4)

This narrow band view includes only the anterior half of the vocal cords from the black lines of photos 1 and 2 to the anterior commissure (at x). Inside the faint circles, note the vascular markings that suggest papilloma formation to explain the serpentine margin.

Tagged Anatomy & Physiology Education