腔镜甲状腺切除术中经环甲间隙入路喉上神经外支的显露

Exposure of the External Branch of the Superior Laryngeal Nerve via Cricothyroid Space in Endoscopic Thyroidectomy

目的:探讨腔镜甲状腺切除术中经环甲间隙入路喉上神经外支的显露技巧,避免术中喉上神经损伤。方法:52例行胸乳/全乳晕入路腔镜甲状腺切除术患者建立颈部操作空间,显露环甲肌,在气管前筋膜间隙切断甲状腺峡部,显露气管,分离环甲间隙,显露环甲肌外侧,在环甲肌外侧的中上部显露喉上神经外支。结果:52例患者(共64条喉上神经)均顺利完成喉上神经外支的显露,术后无声调降低。结论:腔镜甲状腺手术经环甲间隙入路,较容易显露喉上神经外支。

Objective:To explore the skills of exposing the external branch of the superior laryngeal nerve via cricothyroid space in endoscopic thyroidectomy and prevent the superior laryngeal nerve from injury.Methods:Endoscopic thyroidectomy via breast/total areola approach was performed on 52 cases from March 2016 to December 2016 to establish a cervical operating space to expose the cricothyroid muscle.The thyroid isthmus was cut off in the space of pretracheal fascia to expose the trachea.The cricothyroid space was separated to expose the outer side of the cricothyroid muscle.The external branch of the superior laryngeal nerve was was exposed on the middle and upper part of the lateral portion of the cricothyroid muscle.Results:The external branch of the superior laryngeal nerve was exposed successfully in all 52 cases(64 supralaryngeal nerves).No tone was decreased after operation.Conclusion:The external branch of the superior laryngeal nerve is easily to be exposed via cricothyroid space in endoscopic thyroidectomy.