Epiglottic retroversion is difficult to explain anatomically. One reason is inadequate structural identification of the ligaments in the submucosal tissue anterior to the epiglottis (pre-epiglottic space, PES). Although studies have shown that tongue root movement plays a role in epiglottic retroversion, few morphological reports have investigated the attachment of the lingual muscles to the epiglottis. This study reconstructed the fiber structure of the PES by comprehensively analyzing fiber alignment in the PES focusing on the hyoepiglottic ligament, which runs between the lingual muscles and the epiglottis. Gross and microscopic observations of the submucosal structures from the tongue to the larynx of 20 cadavers (10 men, 10 women; mean age 79 years) were performed. A tendon continuing from the posterior part of the genioglossus muscle and attaching to the center of the epiglottic cartilage was identified in the midline area of the epiglottis. We named this tendon the glossoepiglottic tendon. In contrast, the hyoepiglottic ligament is found between the hyoid bone and the epiglottis and is attached from the lateral margin of the epiglottic cartilage to its base. Furthermore, the glossoepiglottic tendon consists of a high-density fiber bundle that is thicker than the hyoepiglottic ligament. These results show that the conventional hyoepiglottic ligament has a two-layer structure consisting of an upper fiber bundle connected to the genioglossus muscle and a lower fiber bundle connected to the hyoid bone. Sustained contraction of the posterior part of the genioglossus muscle therefore places the epiglottis under persistent traction, suggesting that its relaxation may cause epiglottic retroversion.

会厌后倾很难从解剖学上解释。原因之一是会厌前粘膜下组织（会厌前间隙，PES）中韧带的结构识别不充分。尽管研究表明舌根运动在会厌后倾中起作用，但很少有形态学报告研究舌肌与会厌的附着。本研究通过综合分析 PES 中的纤维排列来重建 PES 的纤维结构，重点关注在舌肌和会厌之间运行的舌会厌韧带。对 20 具尸体（10 名男性，10 名女性；平均年龄 79 岁）从舌头到喉部的粘膜下结构进行了肉眼和显微镜观察。在会厌的中线区域识别出从颏舌肌后部延伸并附着到会厌软骨中心的肌腱。我们将这条肌腱命名为舌会厌肌腱。相反，舌骨会厌韧带位于舌骨和会厌之间，并从会厌软骨的外侧边缘连接到其基部。此外，舌会厌肌腱由比舌会厌韧带更厚的高密度纤维束组成。这些结果表明，传统的舌会厌韧带具有两层结构，上层纤维束与膝舌肌相连，下层纤维束与舌骨相连。