Botelho João Bosco, Cardoso Neto José, dos Anjos Gecildo Soriano, de Carvalho Diego Monteiro, de Melo Yanna da Silva, dos Santos Júnior Emanuel Gomes, da Silva Júnior Eduardo Fernandes
Otorhinolaryngology-Cervicofacial Surgery Service, Hospital Adriano Jorge of Universidade do Estado do Amazonas, AM, Brazil.
Rev Col Bras Cir. 2009 Jul;36(3):187-92.
This paper aims to propose a protocol with the topographical relations of the ESLN and the superior thyroid artery in order to minimize the number of flaws in the proposals found in the literature.
the cervical regions of 57 human cadavers from the Forensic Medicine Institute were dissected bilaterally, with photographic identification of the ESLNs and their relation to the superior thyroid artery. These data were used to propose the following classification: Type 1: unidentified ESLN; Type 2: the ESLN crosses the superior thyroid artery 1.5 cm above the upper pole of the thyroid gland; Type 3: the ESLN crosses the superior thyroid artery between 1 and 1.5 cm above the upper pole of the thyroid gland; Type 4: the ESLN crosses the superior thyroid artery less than 1cm above the upper pole of the thyroid gland; Type 5: the ESLN crosses lateral-medially below the upper pole of the thyroid gland. As a supplement, types 2, 3 and 4 received the subclassification: A - the ESLN was partially or totally enclosed in the perimuscular or intramuscular areolar connective tissue, in the inferior pharyngeal constrictor muscle, in more than half of its path after crossing the superior thyroid artery; B - the ESLN was not enclosed in either of these tissues.
Type 1, 11.88%; Type 2, 13.86%; Type 3, 34.65%; Type 4, 38.61%; Type 5, 0.99%.
the majority of the ESLN nearest to the upper pole of the gland (types 3 and 4) followed the perimuscular or intramuscular superficial connective tissue in the upper pole of the thyroid gland, which, in this study, disobliges the systematic identification of the nerve in thyroidectomies (p=0.075).
本文旨在提出一种关于食管下神经（ESLN）与甲状腺上动脉的局部关系的方案，以尽量减少文献中所发现的方案中的缺陷数量。
对法医学研究所57具人类尸体的双侧颈部区域进行解剖，通过照片识别食管下神经及其与甲状腺上动脉的关系。这些数据被用于提出以下分类：1型：未识别出食管下神经；2型：食管下神经在甲状腺上极上方1.5厘米处穿过甲状腺上动脉；3型：食管下神经在甲状腺上极上方1至1.5厘米之间穿过甲状腺上动脉；4型：食管下神经在甲状腺上极上方不到1厘米处穿过甲状腺上动脉；5型：食管下神经在甲状腺上极下方从外侧向内侧穿过。作为补充，2型、3型和4型又分为：A - 食管下神经在穿过甲状腺上动脉后的路径中，超过一半的部分被部分或完全包埋在咽下缩肌的肌周或肌内乳晕结缔组织中；B - 食管下神经未被这些组织中的任何一种包埋。
1型，11.88%；2型，13.86%；3型，34.65%；4型，38.61%；5型，0.99%。
大多数最靠近腺体上极的食管下神经（3型和4型）沿着甲状腺上极的肌周或肌内浅表结缔组织走行，在本研究中，这不利于在甲状腺切除术中对该神经进行系统识别（p = 0.075）。
