上甲状旁腺至喉返神经的入路
Superior parathyroid gland approach to the recurrent laryngeal nerve.
作者信息
Elsheikh Ezzeddin
机构信息
Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
出版信息
Head Neck. 2017 Jul;39(7):1287-1290. doi: 10.1002/hed.24690. Epub 2017 May 11.
BACKGROUND
The superior parathyroid gland is known to be almost constant in its location under the false thyroid capsule. Could it be a landmark to point to the site of incision of the false thyroid capsule and find the plane of the recurrent laryngeal nerve (RLN) during thyroidectomy?
METHODS
The study included 48 patients with benign goiter scheduled for hemithyroidectomy or total thyroidectomy; there were 16 cases of solitary thyroid nodules, 27 cases of multinodular goiter, and 5 cases of toxic goiter.
RESULTS
This study included 80 lobectomies. All patients showed no evidence of postoperative RLN palsy, bleeding, or hypoparathyroidism. The superior parathyroid gland was consistently found within the false capsule in all cases, whereas the inferior parathyroid was found within the same layer in 64 sides (80%).
CONCLUSION
The described approach can accurately guide dissection between true and false capsules of the thyroid to reach and preserve both the RLN and the superior parathyroid gland. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1287-1290, 2017.
背景
已知甲状旁腺上腺在甲状腺假被膜下的位置几乎恒定。在甲状腺切除术中，它能否作为一个标志来指示甲状腺假被膜的切口位置并找到喉返神经（RLN）的平面？
方法
该研究纳入了48例计划行半甲状腺切除术或全甲状腺切除术的良性甲状腺肿患者；其中单发甲状腺结节16例，结节性甲状腺肿27例，毒性甲状腺肿5例。
结果
本研究共进行了80例叶切除术。所有患者术后均未出现喉返神经麻痹、出血或甲状旁腺功能减退的迹象。所有病例中甲状旁腺上腺均始终位于假被膜内，而甲状旁腺下腺在64侧（80%）位于同一层内。
结论
所描述的方法可以准确地指导甲状腺真假被膜之间的分离，以显露并保留喉返神经和甲状旁腺上腺。© 2017威利期刊公司。头颈外科39: 1287 - 1290, 2017。
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