Morton R P, Whitfield P, Al-Ali S
Department of Otorhinolaryngology, Head and Neck Surgery SAMC, Manukau City, Auckland, New Zealand.
Clin Otolaryngol. 2006 Oct;31(5):368-74. doi: 10.1111/j.1749-4486.2006.01266.x.
The anatomical course of the external branch of the superior laryngeal nerve (EBSLN) is variable, and a consistent approach to its preservation during thyroid surgery is needed to reduce risk of post-operative voice impairment. Despite agreement that careful dissection in the region of the superior thyroid pole is required, there is no accepted 'best' approach, nor any universal acknowledgement that location of the EBSLN is actually necessary. The popular cernea classification of EBSLN has limitations, including its decreased reliability with increased thyroid size and its irrelevance in cases of 'buried' variants. * Recent work has identified factors such as ethnicity and stature in the prevalence of EBSLN variants. Consistent approaches to the post-operative detection of EBSLN injury are needed to build an accurate picture of the incidence of surgical nerve injury. Then a standardised approach to EBSLN preservation may emerge.
喉上神经外支（EBSLN）的解剖走行多变，因此在甲状腺手术中需要采用一致的方法来保护该神经，以降低术后声音受损的风险。尽管大家都认同在甲状腺上极区域进行仔细解剖是必要的，但目前尚无公认的“最佳”方法，也没有普遍认可必须明确EBSLN的位置。广为人知的EBSLN的切尔尼亚分类法存在局限性，包括随着甲状腺体积增大其可靠性降低，以及在“隐匿”变异病例中不适用。* 最近的研究已经确定了诸如种族和身高之类的因素与EBSLN变异发生率的关系。需要采用一致的方法来术后检测EBSLN损伤，以便准确了解手术性神经损伤的发生率。这样或许就能出现一种标准化的EBSLN保护方法。
