Devèze A, Sebag F, Hubbard J, Jaunay M, Maweja S, Henry J-F
Department of General and Endocrine Surgery, University Hospital La Timone, France.
Surg Radiol Anat. 2003 Jul-Aug;25(3-4):263-9. doi: 10.1007/s00276-003-0135-9. Epub 2003 Jun 18.
A non-recurrent inferior laryngeal nerve (NRILN) is a rare anomaly that may increase the risk of injury during thyroid surgery. A NRILN results from an embryologic developmental abnormality of the aortic arches, demonstrated by the absence of the brachiocephalic artery and the presence of an aberrant subclavian artery (arteria lusoria). In our experience 100% of 104 patients with a NRILN were shown to have these abnormalities. We postulated that duplex scanning of the brachiocephalic artery could identify patients at risk of a NRILN. Twelve patients with an operative diagnosis of a right NRILN and associated vascular abnormalities underwent postoperative duplex scanning of the brachiocephalic artery. The examination was performed using a 7.5 or 3.5 MHz transducer. The average duration of assessment was 5 min. The absence of the brachiocephalic artery and the direct origin of the right common carotid artery from the arch of the aorta were demonstrated in each patient. Duplex scanning is a simple noninvasive method of identifying patients with the arterial abnormalities responsible for a NRILN. This may be used in the preoperative assessment of selected patients.
非折返性喉返神经（NRILN）是一种罕见的异常情况，可能会增加甲状腺手术期间的损伤风险。NRILN是由主动脉弓的胚胎发育异常引起的，表现为头臂动脉缺如以及存在异常锁骨下动脉（迷走动脉）。根据我们的经验，104例患有NRILN的患者全部被证实存在这些异常情况。我们推测，对头臂动脉进行双功扫描可以识别出有NRILN风险的患者。12例经手术诊断为右侧NRILN并伴有相关血管异常的患者接受了术后头臂动脉双功扫描。检查使用7.5或3.5兆赫的换能器进行。平均评估时长为5分钟。每位患者均显示出头臂动脉缺如以及右颈总动脉直接起自主动脉弓。双功扫描是一种识别患有导致NRILN的动脉异常患者的简单无创方法。这可用于特定患者的术前评估。
