颈部超声预测右侧喉返神经。

Neck ultrasound for prediction of right nonrecurrent laryngeal nerve.

机构信息

Department of General Surgery, Medical College, National Cheng-Kung University, National Cheng-Kung University Hospital and Dou-Liou Branch, Dou-Liou City 64043, Taiwan, Republic of China.

出版信息

Head Neck. 2010 Jul;32(7):844-9. doi: 10.1002/hed.21263.

DOI:10.1002/hed.21263

PMID:19953617

Abstract

BACKGROUND

Nonrecurrent laryngeal nerve (NRLN) is 1 of the important causes for nerve damage during neck surgery. The anomaly is almost associated with congenital vascular abnormally. Most neck vascular anomalies can be detected by ultrasound.

METHODS

Both 3.5-MHz and 10-MHz probe neck ultrasound scans were performed for 2330 patients undergoing thyroidectomy preoperatively. Absence of innominate artery (INA) was defined as positive with right NRLN.

RESULTS

Of 13 positive patients found by 10-MHz probe, 11 were also identified by 3.5-MHz probe, and proved to be with right NRLN during operation. Two false-positive patients (18%) found by 10-MHz probe were due to short INA and tortuous INA, respectively. The incidence of right NRLN was 0.47% in Chinese people. Both the sensitivity and specificity for predicting right NRLN by 3.5-MHz probe were 100%.

CONCLUSION

A 3.5-MHz probe neck ultrasound scan can accurately demonstrate right NRLN. Applying this tool for neck surgery to reduce the nerve damage is highly advised.

摘要

背景

非返性喉神经（NRLN）是颈部手术中神经损伤的重要原因之一。这种异常几乎与先天性血管异常有关。大多数颈部血管异常可以通过超声检测到。

方法

对 2330 例拟行甲状腺切除术的患者进行术前颈 3.5MHz 和 10MHz 探头超声扫描。无名动脉（INA）缺失定义为右侧 NRLN 阳性。

结果

在 10MHz 探头发现的 13 例阳性患者中，11 例也在 3.5MHz 探头中得到证实，且术中证实为右侧 NRLN。2 例 10MHz 探头假阳性患者（18%）分别因短 INA 和 INA 迂曲所致。中国人右侧 NRLN 的发生率为 0.47%。3.5MHz 探头预测右侧 NRLN 的灵敏度和特异性均为 100%。