Watanabe Akihito, Taniguchi Masanobu, Kimura Yuki, Ito Suguru, Hosokawa Masao, Sasaki Shigeyuki
Department of Otolaryngology - Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Japan.
Division of Voice Rehabilitation, Keiyukai Sapporo Hospital, Sapporo, Japan.
Head Neck. 2016 Apr;38(4):573-7. doi: 10.1002/hed.23932. Epub 2015 Jun 20.
The nonrecurrent inferior laryngeal nerve (NRILN) is always associated with the aberrant subclavian artery. CT images can detect this vascular anomaly, which predicts an NRILN. The purpose of this study was to report our procedure to identify the NRILN in patients with the aberrant subclavian artery.
Four of 730 patients undergoing thyroid operation in our hospital were preoperatively diagnosed with aberrant subclavian artery by CT of the neck. To avoid vocal cord paralysis, we approached the vagal nerve first before dissecting the paratracheal region to discover the separation point of the NRILN from the vagal nerve.
The NRILN was identified without difficulty in all 4 patients. No patients showed vocal cord paralysis.
Approaching the vagal nerve first before dissecting the paratracheal region is an efficient, effective, and safe procedure to identify an NRILN in patients who are preoperatively diagnosed as having the aberrant subclavian artery.
非返性喉下神经（NRILN）总是与迷走锁骨下动脉相关联。CT图像能够检测出这种血管异常，而这预示着存在NRILN。本研究的目的是报告我们在迷走锁骨下动脉患者中识别NRILN的方法。
我院730例接受甲状腺手术的患者中有4例术前经颈部CT诊断为迷走锁骨下动脉。为避免声带麻痹，在解剖气管旁区域之前，我们先找到迷走神经，以发现NRILN与迷走神经的分离点。
4例患者均顺利识别出NRILN。无患者出现声带麻痹。
对于术前诊断为迷走锁骨下动脉的患者，在解剖气管旁区域之前先找到迷走神经是一种识别NRILN的高效、有效且安全的方法。
