Lee Mi-Sun, Lee U-Young, Lee Jae-Hoon, Han Seung-Ho
Catholic Institute for Applied Anatomy, Department of Anatomy, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of Korea.
Surg Radiol Anat. 2009 Nov;31(9):649-55. doi: 10.1007/s00276-009-0494-y. Epub 2009 Mar 27.
The present study aims to describe the course of the recurrent laryngeal nerve (RLN) using the tracheoesophageal groove (TEG) at the cricothyroid joint as a base line, and the configuration of RLN and inferior thyroid artery (ITA) for careful dissection in thyroid surgery. The RLN of left side is likely to be found posterior to ITA and course mainly from 0 degrees up to 30 degrees based on TEG near cricothyroid joint while the nerve of right side is likely to be found anterior to ITA in right side and course mainly from 15 degrees up to 45 degrees based on TEG. The contacting point of RLN with ITA locate from the tip of cricoid cartilage at about three tenth of the distance from the tip of cricoid cartilage to sternal notch without reference to individual body size. 70 cadavers were investigated. The angle of RLN from TEG was measured at the cricothyroid joint. The relative position of RLN to ITA was classified. The location of the contacting point of RLN with ITA was measured and converted as an index. These findings suggest the area for careful dissection near cricothyroid joint, the configuration of RLN for identifying the nerve.
本研究旨在以环甲关节处的气管食管沟（TEG）为基线描述喉返神经（RLN）的走行，以及甲状腺手术中用于精细解剖的RLN和甲状腺下动脉（ITA）的形态。左侧RLN可能位于ITA后方，在环甲关节附近以TEG为基准主要走行于0度至30度之间，而右侧神经可能位于右侧ITA前方，以TEG为基准主要走行于15度至45度之间。RLN与ITA的接触点位于环状软骨尖端，距离环状软骨尖端至胸骨切迹距离的约十分之三处，与个体体型无关。对70具尸体进行了研究。在环甲关节处测量RLN与TEG的夹角。对RLN与ITA的相对位置进行分类。测量RLN与ITA接触点的位置并换算为一个指数。这些发现提示了环甲关节附近精细解剖的区域以及用于识别神经的RLN形态。
