喉返神经麻痹的CT表现

The CT features of recurrent laryngeal nerve paralysis

目的分析喉返神经麻痹的CT表现,探讨其解剖和病理形态变化基础,提高对其影像学表现的认识。方法搜集2001至2003年经临床诊断的喉返神经麻痹患者32例,回顾性分析CT资料。所有患者均行全颈部CT增强扫描,范围从舌骨水平到上胸部水平,层厚及间隔均为5 mm。结果喉返神经麻痹后,CT检查可出现一系列相应表现:杓会厌皱襞、杓状软骨及环杓关节前内侧移位,同侧梨状窝扩张、松弛27例(84.4%);喉室扩大16例(50.0%);声带不对称且固定11例(34.4%)等。结论喉返神经支配除环甲肌以外的所有喉内肌,其麻痹后所支配的肌肉群可以发生去神经性萎缩。CT扫描可以有效地显示其相应改变,同时有助于明确麻痹原因。

Objective To describe the CT appearance of recurrent laryngeal nerve paralysis, discuss the anatomic and pathologic basis of this paralysis, and evaluate CT diagnosis. Methods 32 cases of recurrent laryngeal nerve paralysis clinical confirmed were analyzed retrospectively. All of these patients had the CT scans from the level of hyoid bone to the upper thorax, the slice and interval are 5 mm. Results CT findings of recurrent laryngeal nerve paralysis included： oblique of aryepiglottic fold ,dislocation of arytenoids cartilage and cricoarytenoid joint ,dilation and relaxation of piriform sinus for 27 cases （84. 4% ） ; wide and asymmetrical ventricle of larynx for 16 cases （50.0%）;asymmetrical and fix of vocal fold for 11 cases （ 34. 4% ） et al. Conclusion The recurrent laryngeal nerve innervate all the intrinsic muscles of the larynx except cricothyroid muscle, paralysis of the nerve leads to atrophy of related muscles. CT scan demonstrate the larynx morphologic changes of recurrent nerve paralysis and is helpful to identify the etiology.