Department of Surgery, Thyroid Cancer Center, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
Otolaryngol Head Neck Surg. 2011 Aug;145(2):204-7. doi: 10.1177/0194599811406670. Epub 2011 Apr 26.
Nonrecurrent laryngeal nerve (NRLN) is a risk factor for nerve injury during thyroid or parathyroid surgery and is usually associated with vascular anomalies. This study investigated the usefulness of computed tomography (CT) scans for preoperative identification of NRLN in thyroid cancer patients.
Case series with chart review.
Academic university hospital.
Of the 6546 patients, 20 (0.3%) were intraoperatively identified with NRLN, and the medical records of 20 patients were reviewed retrospectively, with particular focus on preoperative CT findings.
All 20 cases were right-sided NRLN, and no clinical symptoms were observed preoperatively in any patient. Two patients had type I NRLN and 18 had type II NRLN. NRLN injury occurred in 1 patient at a point where the nerve was close to the superior thyroid artery. Prior to surgery, surgeons identified only 5 suspected NRLN cases based on identification of vascular anomalies on CT scans. However, this review of CT scans revealed that vascular anomalies could be identified on the scans of all patients.
Neck CT scanning appears to be an excellent method for predicting NRLN cases. However, thorough examination of the scans, with particular attention to the neck and mediastinum vascular structures, is required.
非返性喉返神经（NRLN）是甲状腺或甲状旁腺手术中神经损伤的一个危险因素，通常与血管异常有关。本研究旨在探讨 CT 扫描在甲状腺癌患者术前识别 NRLN 中的作用。
病例系列回顾性研究。
学术大学医院。
在 6546 例患者中，20 例（0.3%）术中发现 NRLN，回顾性分析 20 例患者的病历，特别关注术前 CT 表现。
所有 20 例均为右侧 NRLN，术前无任何患者出现临床症状。2 例为 NRLN Ⅰ型，18 例为 NRLN Ⅱ型。1 例 NRLN 损伤发生在神经靠近甲状腺上动脉的部位。术前，外科医生仅根据 CT 扫描上识别到的血管异常，识别出 5 例疑似 NRLN 病例。然而，对 CT 扫描的回顾性分析显示，所有患者的扫描片上都可以识别到血管异常。
颈部 CT 扫描似乎是预测 NRLN 病例的一种极好方法。然而，需要对扫描片进行彻底检查，特别注意颈部和纵隔血管结构。
