Tubbs R Shane, Loukas Marios, Shoja Mohammadali M, Salter E George, Oakes W Jerry, Blount Jeffrey P
Section of Pediatric Neurosurgery, Department of Cell Biology, University of Alabama at Birmingham, and Children's Hospital Birmingham, Alabama 35233, USA.
J Neurosurg Spine. 2006 Dec;5(6):540-2. doi: 10.3171/spi.2006.5.6.540.
The authors describe a technique in which the cervical portion of the vagus nerve is exposed during procedures such as neuroma resection or, more commonly, during the placement of a vagus nerve stimulator.
To test their hypothesis that a posterolateral approach to the vagus nerve may be feasible and efficacious, the authors performed dissection of the left-sided vagus nerve in 13 adult cadavers. The carotid sheath was exposed via the posterior cervical triangle, and the vagus nerve was identified posterolaterally. Measurements were made of the length of available nerve, and the anatomical approach was documented. As part of a comparison study regarding the available length of nerve, the authors exposed the left vagus nerve in five additional adult cadavers via a standard anterior approach to the carotid sheath, and compared the results obtained with each technique. A mean length of 12 cm of the vagus nerve was isolated when using the posterior approach to the carotid sheath, whereas a mean length of 11 cm of the nerve was documented when using the anterior approach. With the aforementioned posterior approach, no obvious injury occurred to the vagus nerve or other local neurovascular structures such as the spinal accessory nerve.
Evaluation of the findings obtained in the present cadaveric study showed that a posterior approach to the vagus nerve is feasible. The technique for posterior exposure of the carotid sheath may prove useful in surgical exposures of the vagus nerve when a standard anterior method is not possible.
作者描述了一种技术，即在神经瘤切除术等手术过程中，或更常见的是在植入迷走神经刺激器时，暴露迷走神经的颈部部分。
为了验证他们关于迷走神经后外侧入路可能可行且有效的假设，作者对13具成年尸体的左侧迷走神经进行了解剖。通过颈后三角暴露颈动脉鞘，并在其后外侧识别迷走神经。测量可用神经的长度，并记录解剖入路。作为关于神经可用长度的比较研究的一部分，作者通过颈动脉鞘的标准前入路在另外5具成年尸体中暴露左侧迷走神经，并比较了每种技术获得的结果。采用颈动脉鞘后入路时，分离出的迷走神经平均长度为12厘米，而采用前入路时，记录的神经平均长度为11厘米。采用上述后入路时，迷走神经或其他局部神经血管结构（如副神经）未发生明显损伤。
对本尸体研究结果的评估表明，迷走神经后入路是可行的。当标准前入路不可行时，颈动脉鞘后暴露技术可能在迷走神经的手术暴露中有用。
