Jimenez Juan Carlos, Jabori Sinan, Gelabert Hugh A, Moore Wesley S, Quinones-Baldrich William J, O'Connell Jessica
Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Ann Vasc Surg. 2016 May;33:79-82. doi: 10.1016/j.avsg.2015.12.006. Epub 2016 Mar 8.
The presence of a nonrecurrent laryngeal nerve (NRLN) during carotid endarterectomy (CEA) may significantly limit the exposure of the surgical field during this operation. Although its reported incidence is rare, NRLN typically overlies the carotid bifurcation and failure to recognize this anatomic variation increases the risk of NRLN injury. A retrospective chart review of all patients who underwent CEA for hemodynamically significant extracranial carotid stenosis between January 2005 and December 2014 was performed. All patients with NRLN encountered intraoperatively were identified. Clinical outcomes, surgical techniques, and complications were reviewed and reported. Four left-sided NRLN were identified and 4 were right sided. No cranial nerve deficits or injuries occurred after CEA in patients where NRLN was encountered. Two distinct surgical techniques were used to manage patients with NRLN and they are discussed in detail.
在颈动脉内膜切除术（CEA）过程中出现非返喉神经（NRLN）可能会在手术期间显著限制手术视野的暴露。尽管其报告的发生率很低，但NRLN通常覆盖在颈动脉分叉处，未能识别这种解剖变异会增加NRLN损伤的风险。对2005年1月至2014年12月期间因血流动力学显著的颅外颈动脉狭窄而接受CEA的所有患者进行了回顾性病历审查。识别出所有术中遇到NRLN的患者。对临床结果、手术技术和并发症进行了回顾并报告。识别出4例左侧NRLN和4例右侧NRLN。在遇到NRLN的患者中，CEA术后未发生颅神经缺损或损伤。采用了两种不同的手术技术来处理有NRLN的患者，并对其进行了详细讨论。
