喉返神经袢的形态及其临床意义

Morphology and clinical significance of the recurrent laryngeal nerve loop

目的：为甲状腺手术中对喉返神经的定位和保护提供解剖学基础。方法：解剖５０具（１００侧）人颈部尸体标本。在甲状腺手术区对喉返神经袢进行定位观测。结果：（１）喉返神经袢出现率为１３％，左侧占９％；按形态可分“Ｈ”型、“Ｏ”型、混合型。（２）喉返神经袢的最低点距甲状软骨下角尖的距离为３４．５±１５．９ｍｍ。（３）喉返神经袢的最低点距甲状腺下极平面的距离：９％在其平面以上１～１０ｍｍ范围内；２％在其平面；２％在其平面以下１～３ｍｍ范围内。结论：以上喉返神经袢的定位观测结果，为临床甲状腺手术提供了新的解剖学基础。

Objective： To provide anatomic basis for the locati on and protection of the branches of the recurrent laryngeal nerve loop(RLNL)in thyroid surgery.Methods： Fifty adult cadavers(100sides)fixed with formalin were coll ected at random fo r study,The RLNL and its branchse were dissected,observed and measured in the re gion of thyroid surgery.Results： RLNL was found in 13% of the sam ples dissected,of which 9% were on the left side.The loop could be divided into 3 categories:H-s haped,O-shaped ahd mixed.The average of lowest RLNL position was approximately 3 4.5±15.9 mm away from the inferior horn of thyroid.9% if the lowest points were1～10mm ab ove the level of the inferior pole of thyroid gland,2% of the those were 1～3mm below the level of the inferior pole of thyroid gland.Conclusion：The results provide further morphological bases for thyroid surgery.