Furlan J C, de Magalhães R P, de Aguiar E T, Shiroma S
Department of Surgery, Clinical Hospital of the Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Surg Radiol Anat. 2002 Aug-Sep;24(3-4):190-3. doi: 10.1007/s00276-002-0025-6. Epub 2002 Jul 12.
Knowledge of the topographic anatomy is essential to prevent iatrogenic damage of the superior laryngeal nerve (SLN) in carotid endarterectomy (CEA). The purpose of this study was to analyze the anatomic relationship between the SLN and carotid arteries in order to prevent iatrogenic nerve injury. Anatomic dissections similar to CEA were performed bilaterally in 50 fresh human adult cadavers. The topography of the SLN was analyzed regarding its relationship with the carotid arteries. Furthermore, the distance between the external branch of the SLN and the point of bifurcation of the common carotid artery (dCAB) was analyzed regarding effects of gender, ethnicity, individual stature and side of the neck. The SLN was always located adjacent and posterior to the carotid arteries.The dCAB ranged from 20.3 mm below the point of bifurcation of the common carotid artery to 50.9 mm above this level (average 10.3 mm above). Most dissections (75%) showed the external branch of the SLN emerging from behind the carotid artery above the arterial bifurcation; in only 10% of cases did this nerve emerge from the artery below that anatomic reference. Based on Student's t-test, there were no significant differences in the dCAB between genders ( P=0.237), ethnicities ( P=0.410) and sides of the neck ( P=0.872). Moreover, tall stature was not significantly correlated with a shorter dCAB (linear regression: R(2)=0.009, P=0.357). We conclude that most SLNs were located above the carotid artery bifurcation, but anatomic variations occurred in 25% of the dissections. The dCAB was unaffected by gender, ethnicity, individual stature and side of the neck.
了解局部解剖学对于预防颈动脉内膜切除术（CEA）中喉上神经（SLN）的医源性损伤至关重要。本研究的目的是分析SLN与颈动脉之间的解剖关系，以预防医源性神经损伤。在50具新鲜成人人类尸体上双侧进行了类似于CEA的解剖。分析了SLN的局部解剖结构及其与颈动脉的关系。此外，分析了SLN外支与颈总动脉分叉点之间的距离（dCAB），探讨性别、种族、个体身高和颈部侧别对其的影响。SLN总是位于颈动脉的相邻后方。dCAB的范围从颈总动脉分叉点下方20.3毫米到该水平上方50.9毫米（平均上方10.3毫米）。大多数解剖（75%）显示SLN外支从动脉分叉上方的颈动脉后方发出；只有10%的病例中该神经从动脉分叉下方发出。基于学生t检验，dCAB在性别（P = 0.237）、种族（P = 0.410）和颈部侧别（P = 0.872）之间没有显著差异。此外，高身材与较短的dCAB没有显著相关性（线性回归：R² = 0.009，P = 0.357）。我们得出结论，大多数SLN位于颈动脉分叉上方，但25%的解剖存在解剖变异。dCAB不受性别、种族、个体身高和颈部侧别的影响。
