Menck J, Grüber J, Lierse W
Abteilung für Neuroanatomie, Anatomisches Institut der Universität Hamburg.
Unfallchirurg. 1990 Aug;93(8):384-6.
It is well known that the recurrent laryngeal nerve is often damaged during or following an anterior approach to the cervical vertebral column. Reports in the literature suggest that the right-sided approach gives rise to more complications of the recurrent nerve than the left-sided approach and that the right recurrent nerve is in a less protected position. There are also studies addressing the risks involved in the right-sided and the left-sided approach and suggesting the opposite conclusion. In our study, the position of the recurrent nerve was found to be variable and even to be different on the right and left sides in the same person. In 44.6% of cases (45 of 101) the recurrent nerve was found to be have an intermediate course (at the dorsal edge of the trachea or in the sulcus between trachea and esophagus) on both sides. The recurrent nerve was in an anterior position (lateral of the ventral two-thirds or the dorsal one-third of the trachea) in 50.5% (51 cases) on the left and in 49.5% (50 cases) on the right. A posterior position (lateral to the esophagus) of the recurrent nerve was found in 4.9% (5 cases) on the left and in 5.9% (6 cases) on the right. All combinations are possible. The position of the recurrent nerve cannot be inferred from its position on the opposite side. The right-sided or the left-sided approach cannot be preferred on the basis of the position of the recurrent nerve.(ABSTRACT TRUNCATED AT 250 WORDS)
众所周知，在颈椎前路手术期间或术后，喉返神经常受到损伤。文献报道表明，右侧入路比左侧入路引发更多喉返神经并发症，且右侧喉返神经所处的保护位置较差。也有研究探讨了右侧和左侧入路所涉及的风险，并得出了相反的结论。在我们的研究中，发现喉返神经的位置是可变的，甚至在同一个人的左右两侧也有所不同。在44.6%的病例（101例中的45例）中，双侧喉返神经走行于中间位置（在气管背侧边缘或气管与食管之间的沟内）。左侧有50.5%（51例）、右侧有49.5%（50例）的喉返神经位于前方位置（在气管腹侧三分之二或背侧三分之一的外侧）。左侧有4.9%（5例）、右侧有5.9%（6例）的喉返神经位于后方位置（在食管外侧）。所有组合皆有可能。不能根据喉返神经在对侧的位置来推断其在同侧的位置。不能基于喉返神经的位置而优先选择右侧或左侧入路。（摘要截选于250词）
