Citton Marilisa, Viel Giovanni, Iacobone Maurizio
Endocrine Surgery Unit, University of Padua, Padova, Italy.
Gland Surg. 2016 Dec;5(6):583-590. doi: 10.21037/gs.2016.11.07.
Non-recurrent laryngeal nerve (NRLN) is a rare anatomical variant (0.3-6%) that is associated with some arterial abnormalities (absence of the brachiocephalic trunk and presence of a right aberrant subclavian lusorian artery). The availability of a preoperative diagnosis of NRLN may reduce the risk of nerve injuries. Preoperative ultrasonography (US) has been suggested as a reliable diagnostic tool to detect the arterial abnormalities associated with NRLN, but the literature is relatively scarce. This paper was aimed to review the literature, in order to offer an up to-date on this technique and its results.
A web search, focusing on humans, was performed by PubMed database, including papers published up to August 2016, using the key words "ultrasonography" AND "non-recurrent laryngeal nerve" or "nonrecurrent laryngeal nerve".
Eight papers, including 3,740 patients who underwent neck US for the detection of NRLN were selected. Only five studies focused on the preoperative use of US. The incidence of NRLN varied between 0.4% and 1.94%. The sensitivity and specificity varied between 99-100% and 41-100%, respectively.
US is a simple, non-invasive and cost-effective method to detect NRLN, also if its accuracy is not absolute. It may be used preoperatively and to prevent the intraoperative nerve damage, since the risk of NRLN palsies is significantly reduced when a preoperative diagnosis is available.
非喉返神经（NRLN）是一种罕见的解剖变异（发生率为0.3% - 6%），与一些动脉异常有关（如头臂干缺如及右侧迷走锁骨下动脉）。术前诊断NRLN可降低神经损伤风险。术前超声检查（US）被认为是检测与NRLN相关动脉异常的可靠诊断工具，但相关文献相对较少。本文旨在回顾文献，以提供该技术及其结果的最新情况。
通过PubMed数据库进行网络搜索，聚焦于人类研究，检索截至2016年8月发表的论文，关键词为“超声检查”和“非喉返神经”或“nonrecurrent laryngeal nerve”。
共筛选出8篇论文，包括374名接受颈部超声检查以检测NRLN的患者。仅有5项研究关注超声检查的术前应用。NRLN的发生率在0.4%至1.94%之间。敏感性和特异性分别在99% - 100%和41% - 100%之间。
超声检查是检测NRLN的一种简单、无创且经济有效的方法，尽管其准确性并非绝对。它可用于术前预防术中神经损伤，因为术前诊断可显著降低NRLN麻痹的风险。
