部分膈神经与喉返神经前支吻接治疗双侧喉麻痹的显微外科解剖

MICROSURGICAL ANATOMY FOR ARTIFICIAL ANASTOMOSIS BETWEEN A SPLIT-PHRENIC NERVE AND THE ANTERIOR BRANCH OF RECURRENT LARYNGEAL NERVE IN LARYNX PARALYSIS

借助SXP-I型手术显微镜,观察测量了30例成人膈神经(颈段)的起源、长度、位置和血供,以及喉返神经前支在喉内的主要分支,结合组织学、AchE组织化学方法,观察了膈神经,喉返神经前支的横截面积,神经束、有髓纤维和运动纤维的数目;提出了用部分膈神经与喉返神经前支吻接结合喉返神经侧肌支切断植入环杓后肌的方法以治疗双侧喉返神经损伤引起喉麻痹的手术设想。

The origin, length, location and blood supply of the phrenic nerves (cervical part) and those of the primary branches of the recurrent laryngeal nerves(RLN) inside the larynx were observed and measured in 30 cases of human beings with the help of the SXP-I type of operating microscope.Also, the areas of the nerve fascicles, myelinated fibers or motor fibers in relation to both the phrenic nerves and the anterior branches were identified by histological or AchE histochemical methods and were counted and calculated by planimeter under microscope.An operating procedure of anastomosing a split-phrenic to the anterior branch plus planting the distal end of the lateral branch of RLN into the poterior cricoarytenoid muscle was put up for the reinnervation of the paralyzed abductors of vocal cords.