The vocal ligaments and vocalis muscles insert at the anterior commissure of the thyroid cartilage. The biomechanical function of the connective tissue of the insertion is to equalise the different elastic modules of tendons and cartilage or bone. Structures of the insertion of plica vocalis at the anterior commissure are clinically important considering the spread of carcinoma that can grow along the vocal ligament in a ventral direction. The lack of perichondrium or periosteum in the area of insertion, ossification of the thyroid cartilage and the associated vascularisation of the skeleton allow the invasion of tumours in the thyroidal skeleton.