Liu Hongjian, Lou Weihua
Department of Otolaryngology, Henan Province People's Hospital, Zhengzhou, 450003, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Mar;24(6):273-5.
To locate the recurrent laryngeal nerve fascicles in vagus and investigate the effect of the split-vagus nerve procedure to repair the paralyzed vocal cord in rats.
The method of dissection and acetylcholinesterase histochemical staining of neural fibers were used to locate the recurrent laryngeal nerve fascicles in vagus. Then 60 SD rats were divided into three groups. In experimental group right recurrent laryngeal nerve were incised and anastomosed to recurrent laryngeal nerve fascicles in vagus by means of the split-vagus nerve procedure. In control group right recurrent laryngeal nerve were incised and sutured immediately by means of end-to-end nerve anastomosis. In normal group rats were not treated by any elements. Three months later, rats from each group were examined for vocal cord movement and nerve regeneration by using fibrolaryngoscope and nerve electromyography.
The recurrent laryngeal nerve fascicles is in the medial-anterior segment of the vagus and its diameter is about one-fourth as large as the vagus. Three months after operation, the effect of the split-vagus nerve procedure bad not significant difference compared with the control group (P > 0.05).
The location of the recurrent laryngeal nerve fascicles in vagus provides important anatomical guideline for surgery. The split-vagus nerve procedure has a similar treatment effect compared with end-to-end nerve anastomosis. This microsurgical technique provides a new method for repairing recurrent laryngeal nerve.
定位迷走神经内的喉返神经束,并研究迷走神经劈开术修复大鼠麻痹声带的效果。
采用解剖方法和神经纤维乙酰胆碱酯酶组织化学染色法定位迷走神经内的喉返神经束。将60只SD大鼠分为三组。实验组切断右侧喉返神经,通过迷走神经劈开术将其与迷走神经内的喉返神经束吻合。对照组切断右侧喉返神经,立即行端端神经吻合术缝合。正常组大鼠不做任何处理。三个月后,使用纤维喉镜和神经肌电图检查每组大鼠的声带运动和神经再生情况。
喉返神经束位于迷走神经的内侧前段,其直径约为迷走神经的四分之一。术后三个月,迷走神经劈开术与对照组相比效果无显著差异(P>0.05)。
迷走神经内喉返神经束的定位为手术提供了重要的解剖学指导。迷走神经劈开术与端端神经吻合术具有相似的治疗效果。这种显微外科技术为喉返神经修复提供了一种新方法。