喉返神经喉外分支的临床意义(附13例报告)

Clinical Significance of Extralaryngeal Furcation of the Recurrent Laryngeal Nerve(A Report of 13 Cases).

目的 :了解喉返神经喉外分支的解剖特点发病情况和术中喉返神经损伤的原因。方法 :1 991年至 2 0 0 1年共收治行甲状腺叶切除术的病人 1 4 5例 ,术中常规解剖暴露喉返神经。结果 :本组共发现喉返神经喉外分支 1 3例 ,占9%。男 4例 ,女 9例 ,平均年龄 46岁 ,右侧 9例 ,左侧 4例。喉返神经喉外分支分为 2支者 1 0例 ,占 76 .9% ,3支者 2例 ,1例为 4个分支。喉外分支点距环甲关节入喉处的距离多在 2cm以上 ,有的甚至低于甲状腺下动脉平面。结论 :喉返神经有时常在喉外分为 2或 3个分支 ,为避免在甲状腺切除手术时损伤喉返神经 。

To study the extralaryngeal furcation of the recurrent laryngeal nerve and analyze its role in recurrent laryngeal nerve injury during operation. Methods: Unilateral lobectomy of the thyroid was performed in 145 patients from 1991 to 2001. The recurrent laryngeal nerve was exposed routinely. Results: Extralaryngeal furcation was identified in 13/145(9%) cases. There were 4 males and 9 females, with an average age of 46 years. The furcations in 9 cases were located on the right side and in 4 on the left. Ten patients had bifurcations, 2 had trifurcations and 1 had tetrafurcations. All the branchings were located more than 2 cm from the cricoid cartilage, some were situated even below the inferior thyroid artery. Nerve injury occurred in 4 patients. Conclusions: In order to prevent recurrent laryngeal nerve injury during thyroidectomy, the nerve should be exposed routinely during operation.