Anterior commissure of the vocal folds

The anterior commissure of the vocal folds is the region at the anterior midline of the glottis where the right and left true vocal folds meet and attach to the thyroid cartilage.

Anatomically, it consists of the ventral insertions of the vocal folds, including the anterior macula flava, and is anchored to the intermediate lamina of the thyroid cartilage just below the superior thyroid notch. This region also incorporates Broyles' ligament (commissural tendon), the connective tissue between Broyles' and the conoid ligaments, and the insertion fibers of the vocal muscles, forming a unified anatomical and developmental structure.

This area is clinically significant due to its role in the spread of glottic carcinoma and its unique connective tissue composition, which influences tumor progression and surgical approaches. The anterior commissure is typically identifiable as a narrow band, with imaging studies showing its width to be approximately 1–2 mm in healthy adults.[3-The precise anatomical definition, including its developmental origins and connective tissue components, is essential for understanding both normal laryngeal function and pathological processes involving the glottis.