Department of Otolaryngology-Head and Neck Surgery, Buddist Tzu Chi General Hospital, Taipei Branch School of Medicine, Tzu Chi University, Hualien; Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Laryngoscope. 2015 Feb;125(2):419-23. doi: 10.1002/lary.24944. Epub 2014 Sep 30.
OBJECTIVES/HYPOTHESIS: To better understand the reason for the low success rate of posterior cricoarytenoid (PCA) muscle reinnervation, we attempted to identify the communicating branches that may exist between the nerve branch to the PCA muscle and the other laryngeal adductors in addition to the interarytenoid (IA) muscle.
Quantitative histological assessment.
Twenty human hemilarynges from patients with laryngeal or hypopharyngeal cancer were obtained after surgery and stained with Sihler's stain, which rendered the muscle translucent while counterstaining the neuroanatomy of the recurrent laryngeal nerve (RLN) inside the larynges.
The nerve supply to the PCA muscle was separated into two main branches. One upper branch supplied the horizontal compartment, and the lower branch supplied the vertical/oblique compartment. In 14 specimens, two nerve branches to the PCA muscle arose separately from the RLN. In six specimens, one single main branch arose from the RLN and immediately ramified into two secondary branches. In all specimens except one, the nerve branch to the horizontal compartment was connected to the IA muscle. However, no communicating branches were observed between the nerve to the PCA muscle and the other laryngeal adductors. No anastomosis between nerve branches to the horizontal and vertical/oblique compartments or other variations of nerve distribution were observed.
The communicating branches between the nerve branches to the PCA muscle and the IA muscle may be the only branch, complicating the reinnervation procedure. More investigations are needed to identify variations in the terminal branch distribution from the RLN.
NA.
目的/假设：为了更好地理解后环杓肌（PCA）肌神经再支配成功率低的原因，我们试图确定除杓间肌（IA）肌之外，PCA 肌神经分支与其他喉内收肌之间可能存在的交通支。
定量组织学评估。
从接受喉或下咽癌手术的 20 例患者的半喉中获得标本，并用 Sihler 染色法染色，使肌肉半透明，同时对喉内的喉返神经（RLN）的神经解剖结构进行复染。
PCA 肌的神经供应分为两个主要分支。一个上支供应水平部，下支供应垂直/斜部。在 14 个标本中，有两个 PCA 肌神经分支分别发自 RLN。在 6 个标本中，有一个单一的主支发自 RLN，并立即分为两个次级支。除了一个标本外，所有标本的 PCA 肌水平部神经分支都与 IA 肌相连。然而，在 PCA 肌神经和其他喉内收肌之间没有观察到交通支。没有观察到水平和垂直/斜部神经分支之间的吻合或其他神经分布的变异。
PCA 肌神经分支与 IA 肌之间的交通支可能是唯一的分支，这使再神经支配的过程复杂化。需要进一步的研究来确定 RLN 终末分支分布的变异。
无。
