喉返神经喉外分支的显微解剖及临床意义

发布时间：2018-11-29 12:37

【摘要】：目的探讨甲状腺手术区域喉返神经(RLN)的解剖特点和方法。方法运用大体解剖的方法,对48例成人标本甲状腺手术区域的RLN及其周围毗邻结构进行了观测。结果 48例96侧成人标本中,29%RLN主干穿过环咽肌肌束至致密结缔组织膜下缘,71%RLN主干走行在环咽肌深面。69%RLN在距离甲状软骨下角尖端(15.2±5.5)mm处分为前、后两支,前支多于环状软骨侧方下缘距离甲状软骨下角尖端(5.9±1.8)mm处穿过结缔组织膜,后支入喉点距甲状软骨下角尖端(4.8±2.1)mm;31%RLN未见分支。结缔组织膜下缘RLN与甲状腺下动脉(ITA)分支的关系为:66%(63/96)RLN位于ITA前方,27%(32/96)位于ITA后方。结论大多数RLN具有喉外分支,在以甲状软骨下角作为标志寻找RLN时,要同时找寻RLN及喉外分支的入喉点。ITA与RLN的关系复杂多变,ITA不作为RLN定位的首选。
[Abstract]:Objective to investigate the anatomical characteristics and methods of (RLN) of recurrent laryngeal nerve in thyroid surgery area. Methods the RLN and its adjacent structures in 48 adult specimens of thyroid surgery were observed by gross anatomy. Results in 96 adult specimens of 48 cases, the 29%RLN trunk passed through the muscle bundle of the cricopharyngeal muscle to the inferior edge of dense connective tissue membrane, and the 71%RLN trunk was on the deep side of the circular pharyngeal muscle. 69%RLN was disposed before the tip of the inferior angle of thyroid cartilage (15.2 卤5.5) mm. The posterior two branches, with more anterior branches than annular cartilage, passed through the connective tissue membrane from the tip of the inferior horn of thyroid cartilage (5.9 卤1.8) mm, and the point of the posterior branch into the larynx was (4.8 卤2.1) mm; from the tip of the inferior angle of thyroid cartilage. No branches were found in 31%RLN. The relationship between connective tissue membrane RLN and (ITA) branch of inferior thyroid artery was 66% (63 / 96) RLN in front of ITA and 27% (32 / 96) behind ITA. Conclusion most RLN have extralaryngeal branches. When looking for RLN with the sublaryngeal angle of thyroid cartilage as a marker, we should find the entry point of RLN and extralaryngeal branches at the same time. The relationship between ITA and RLN is complex and changeable, and ITA is not the first choice for RLN localization.
【作者单位】：合肥市第二人民医院和平路院区耳鼻喉科;安徽医科大学人体解剖学教研室;
【分类号】：R322.32

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