中间入路解剖喉返神经在甲状腺全切和次全切除术中应用

Medial approach for recurrent laryngeal nerve dissection in total thyroidectomy and subtotal thy-roidectomy

目的探讨中间入路解剖喉返神经在甲状腺全切和次全切除术应用的作用。方法对281例中间入路解剖喉返神经在甲状腺全切和次全切除术应用的临床资料进行回顾性分析。结果281例在术中共解剖喉返神经537条。术后出现声音嘶哑3例，其中2例经消肿、营养神经治疗2周内发音恢复正常；1例声音嘶哑症状改善，但未能完全康复，6个月后喉镜检查声带考虑永久性麻痹。结论为减少喉返神经损伤，在甲状腺手术中运用中间入路解剖喉返神经是一种更安全有效的新方法。

Objective To study the effect of medial approach section in total thyroidectomy and subtotal thyroidectomy. Methods on recurrent laryngeal nerve dis-The clinical data of 281 patients with medial approach for recurrent laryngeal nerve dissection in total thyroidectomy and subtotal thyroid- ectomy were analyzed. ResuLts Five hundred and thirty - seven recurrent laryngeal nerve were dissected during the surgery. There were 3 cases of hoarseness after operation. Two cases were treated by relieving swelling, nerve nutrition for two weeks, the pronunciation returned to normal. One case of hoarseness im-proved, but not fully recovered, and was considered permanent paralysis after laryngoscopy six months later. Conclusions In order to reduce the recurrent laryngeal nerve injury, the method of medial ap-proach to anatomy the recurrent laryngeal nerve is safe and effective in thyroid surgery.