Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea.
Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea.
Sci Rep. 2017 Nov 2;7(1):14952. doi: 10.1038/s41598-017-15070-9.
Injury to the external branch of the superior laryngeal nerve (eSLN) can cause a hoarse or weak voice with dysergia of the cricothyroid. The present study provided the topographic information of the eSLN in the Asian and verified anatomical validity of the landmarks previously recruited to localize the eSLN. Thirty specimens were dissected from 16 human embalmed cadavers (12 men and four women; mean age: 80.5 years). The vertical distance between the eSLN and the apical pole of the thyroid gland (AP) was 8.2 ± 4.2 mm. It descended over the AP with <1 cm distance in 51.7%, >1 cm distance in 27.6% and under the AP in 20.7%. The piercing point (PP) of the eSLN to the muscles located 26.0 ± 5.5 mm posterior and 14.7 ± 5.0 mm inferior to the laryngeal prominence. Generally, the PP located superoposterior to the midpoint of the joint between the joint of inferior constrictor and cricothyroid (ICJ). The distance between the PP and the midpoint was 8.7 ± 5.1 mm. We found that 1) the Asian had the eSLN located over the AP with <1 cm distance about half cases, 2) the PP can be a consistent reference for the eSLN identification, 3) the ICJ can be a useful landmark to preserve the eSLN at the PP.
喉上神经外支（eSLN）损伤可导致声嘶或声音微弱，并伴有环甲肌协同失调。本研究提供了 eSLN 在亚洲的解剖位置信息，并验证了之前用于定位 eSLN 的解剖标志的解剖学有效性。在 16 具防腐固定的人体标本（12 名男性和 4 名女性；平均年龄：80.5 岁）中解剖了 30 个标本。eSLN 与甲状腺上极（AP）之间的垂直距离为 8.2±4.2mm。在 51.7%的标本中，eSLN 在 AP 下方距离<1cm 处下降；在 27.6%的标本中，eSLN 在 AP 上方距离>1cm 处下降；在 20.7%的标本中，eSLN 在 AP 下方距离<1cm 处下降。eSLN 穿出点（PP）位于甲状软骨后 26.0±5.5mm 和喉结下 14.7±5.0mm 处的肌肉。一般来说，PP 位于下咽缩肌和环甲肌关节（ICJ）中点的后上方。PP 与中点之间的距离为 8.7±5.1mm。我们发现：1）亚洲人的 eSLN 有一半位于 AP 上方，距离<1cm；2）PP 可以作为识别 eSLN 的一个恒定参考；3）ICJ 可以作为在 PP 处保护 eSLN 的有用标志。
