Ryan Stephen, McNicholas Walter T, O'Regan Ronan G, Nolan Philip
Department of Human Anatomy and Physiology, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin 2, Ireland.
J Anat. 2003 May;202(5):421-30. doi: 10.1046/j.1469-7580.2003.00177.x.
We undertook this study to determine the detailed neuroanatomy of the terminal branches of the recurrent laryngeal nerve (RLN) in the rabbit to facilitate future neurophysiological recordings from identified branches of this nerve. The whole larynx was isolated post mortem in 17 adult New Zealand White rabbits and prepared using a modified Sihler's technique, which stains axons and renders other tissues transparent so that nerve branches can be seen in whole mount preparations. Of the 34 hemi-laryngeal preparations processed, 28 stained well and these were dissected and used to characterize the neuroanatomy of the RLN. In most cases (23/28) the posterior cricoarytenoid muscle (PCA) was supplied by a single branch arising from the RLN, though in five PCA specimens there were two or three separate branches to the PCA. The interarytenoid muscle (IA) was supplied by two parallel filaments arising from the main trunk of the RLN rostral to the branch(es) to the PCA. The lateral cricoarytenoid muscle (LCA) commonly received innervation from two fine twigs branching from the RLN main trunk and travelling laterally towards the LCA. The remaining fibres of the RLN innervated the thyroarytenoid muscle (TA) and comprised two distinct branches, one supplying the pars vocalis and the other branching extensively to supply the remainder of the TA. No communicating anastomosis between the RLN and superior laryngeal nerve within the larynx was found. Our results suggest it is feasible to make electrophysiological recordings from identified terminal branches of the RLN supplying laryngeal adductor muscles separate from the branch or branches to the PCA. However, the very small size of the motor nerves to the IA and LCA suggests that it would be very difficult to record selectively from the nerve supply to individual laryngeal adductor muscles.
我们开展这项研究,以确定兔喉返神经(RLN)终末分支的详细神经解剖结构,以便将来能从该神经的特定分支进行神经生理学记录。对17只成年新西兰白兔进行死后全喉分离,并采用改良的西勒氏技术进行处理,该技术可使轴突染色并使其他组织透明,从而能在整装标本中观察到神经分支。在处理的34个半喉标本中,28个染色良好,对这些标本进行解剖,用于描述RLN的神经解剖结构。在大多数情况下(23/28),环杓后肌(PCA)由RLN发出的单个分支供应,不过在5个PCA标本中,有两到三个独立分支供应PCA。杓间肌(IA)由RLN主干在发出至PCA的分支之前发出的两条平行细丝供应。环杓侧肌(LCA)通常由RLN主干分出的两条细支支配,这两条细支向外侧走行至LCA。RLN的其余纤维支配甲杓肌(TA),并分为两个不同分支,一个供应声带部,另一个广泛分支供应TA的其余部分。未发现喉内RLN与喉上神经之间有交通吻合支。我们的结果表明,从RLN供应喉内收肌的特定终末分支进行电生理记录是可行的,这些分支与供应PCA的分支分开。然而,支配IA和LCA的运动神经非常细小,这表明很难选择性地记录单个喉内收肌的神经供应。