Regional variations and sex-related differences of stiffness in human tracheal ligaments

Surg Radiol Anat. 2024 Apr 29. doi: 10.1007/s00276-024-03361-6. Online ahead of print.

Abstract

Purpose: There have been numerous studies focused on the stiffness of tracheal cartilage. However, no research has been conducted specifically on the annular ligament, nor have any regional differences in the annular ligament been identified. The purpose of this study was to investigate the stiffness of the ligaments present between the thyroid, cricoid and tracheal cartilages.

Methods: The ligaments were identified in the cervical region of living subjects with ultrasonography. The stiffness of the ligaments was measured from the body surface using a digital palpation device (MyotonPRO). Since it is impossible to measure the entire trachea in a living subject, an additional measurement was performed on human cadavers.

Results: Both in vivo and cadaveric investigations found that the stiffness of annular ligaments decreased gradually from the superior to inferior parts. There was no difference in the stiffness between males and females in the superior part of the trachea. However, the stiffness of the middle and inferior parts was predominantly higher in females than in males. Furthermore, males showed significant differences in stiffness between the superior and middle parts, while females showed no significant differences.

Conclusion: These results reveal that there are regional and sex-related differences in the stiffness of human tracheal ligaments.

Keywords: Annular ligament; Sex-related difference; Stiffness; Trachea.