Otorhinolaryngology Service, Infanta Sofía University Hospital, Madrid, Spain.
Human Anatomy and Embryology Department, School of Medicine, Complutense University of Madrid, Madrid, Spain.
Head Neck. 2018 Sep;40(9):1926-1933. doi: 10.1002/hed.25186. Epub 2018 Apr 23.
Because external laryngeal nerve (ELN) iatrogenic damage is frequent during neck surgery, its precise localization has been highly recommended. This study analyzes the different surgical landmarks previously proposed and the anatomy of the collateral and terminal branches of the ELN.
The necks of 157 (77 men and 80 women) human adult embalmed cadavers were examined. The ELN origin, length, and relationship to different landmarks were recorded and results statistically compared with those previously reported.
The ELN is located deep to the ascending pharyngeal vein in 100% of patients. In most patients, it crosses the carotid axis at the thyroid artery origin level (47% of patients), passes medial to it (89% of patients), and shows an intramuscular trajectory through the inferior constrictor of the pharynx (80% of patients).
The ELN position, in relation to classical landmarks, is highly variable. The most reliable relationships are those with the ascending pharyngeal vein or with the superior thyroid artery.
由于颈部手术中经常发生喉返神经（ELN）医源性损伤，因此强烈建议对其进行准确定位。本研究分析了先前提出的不同手术标志点以及 ELN 的侧支和终末分支的解剖结构。
检查了 157 具（77 名男性和 80 名女性）成人防腐尸体的颈部。记录了 ELN 的起源、长度以及与不同标志点的关系，并将结果与之前报道的结果进行了统计学比较。
在 100%的患者中，ELN 位于咽升静脉深部。在大多数患者中，它在甲状腺动脉起源水平穿过颈动脉轴（47%的患者），位于其内侧（89%的患者），并通过咽的下缩肌呈现肌内轨迹（80%的患者）。
ELN 相对于经典标志点的位置高度可变。与咽升静脉或甲状腺上动脉最相关。
