Reeve’s Cricothyroid Space

  • Reeve’s Cricothyroid Space:
    • Synonym:
      • Paralaryngingeal space
      • Pemberton space
      • Inter-laryngeal glandular space
  • The lower and lateral retraction of the upper thyroid pole:
    • Reveals a diamond-shaped avascular space
  • The area is limited:
    • Medially:
      • By the lamina of the thyroid cartilage (superiorly) and cricoid cartilage (inferiorly):
        • Both covered by the cricothyroid muscle
    • Inferolaterally:
      • The space is circumscribed by the medial border of the upper thyroid pole and the upper border of the thyroid isthmus
    • The “roof” of the area:
      • Is covered by 2 or 3 “bridging” blood vessels that must be controlled to access the space
  • The “opening” of this virtual space:
    • Prior to the ligature of the upper thyroid pedicle:
      • Is a safety maneuver to protect the external branch of the superior laryngeal nerve
  • Landmarks:
    1. Thyroid cartilage
    2. Reeve cricothyroid space
    3. Space with “bridging” blood vessels
    4. Upper thyroid pole
    5. Cricothyroid muscle
    6. External branch of the superior larngeal nerve
    7. Superior thyroid artery
    8. Superior thyroid vein
  • Reference:
    • Abdullah H, Bliss R, Reeve T, Delbridge L (2000) Recognition of the avascular space medial to the upper pole of the thyroid and its surgical implications. Asian J. Surg. 23: 86–9.
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