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美国人群中胸部左侧喉返神经、动脉韧带、主动脉弓和肺动脉的尸体测量及其临床意义和两性比较

Cadaveric Measurements of the Left Recurrent Laryngeal Nerve, Ligamentum Arteriosum, Aortic Arch, and Pulmonary Artery in the Thorax with Clinical Implications and Comparison Between Two Sexes in the American Population.

作者信息

Ghosh Anasuya, Chaudhury Subhramoy

机构信息

Anatomy, Medical University of the Americas, Charlestown, KNA.

出版信息

Cureus. 2019 Jun 4;11(6):e4828. doi: 10.7759/cureus.4828.

Abstract

The left recurrent laryngeal nerve (RLN) is prone to get compressed or damaged, leading to vocal cord palsy, due to pathologies or surgeries of the structures closely surrounding this nerve in the thorax, including the esophagus, aortic arch, pulmonary trunk, and ligamentum arteriosum. We wanted to provide a data set including nerve diameter, its distance from the esophagus, measurements of the pulmonary artery, aorta, and ligamentum arteriosum in close proximity of the nerve in a healthy population to avoid its damage during surgery and predict its chances of compression during the diseased condition. We measured the left RLN and the surrounding structures in 39 well-embalmed cadavers. We compared the values among the male and female cadavers. We found that the mean diameter of the left RLN was 1.75 mm, the mean distance of the nerve from esophagus was 9.88 mm, the mean diameters of the aortic arch and pulmonary artery just distal to the attachment of the ligamentum arteriosum were 26.14 and 19.93 mm, respectively, and the length and width of ligamentum arteriosum were 15.89 and 2.79 mm, respectively. No clinically significant differences were found between male and female parameters. This set of values might be useful while investigating the cause of vocal cord palsies or during surgeries in close proximity to left RLN to avoid its damage.

摘要

由于胸部中紧邻左喉返神经(RLN)的结构(包括食管、主动脉弓、肺动脉和动脉韧带)发生病变或进行手术,左喉返神经容易受到压迫或损伤,进而导致声带麻痹。我们希望提供一个数据集,其中包括健康人群中神经直径、其与食管的距离、紧邻神经的肺动脉、主动脉和动脉韧带的测量值,以避免手术期间损伤该神经,并预测疾病状态下其受压的可能性。我们在39具保存良好的尸体中测量了左喉返神经及其周围结构。我们比较了男性和女性尸体之间的数值。我们发现,左喉返神经的平均直径为1.75毫米,神经与食管的平均距离为9.88毫米,动脉韧带附着点远端的主动脉弓和肺动脉的平均直径分别为26.14毫米和19.93毫米,动脉韧带的长度和宽度分别为15.89毫米和2.79毫米。男性和女性参数之间未发现临床显著差异。这组数值在调查声带麻痹的原因或在紧邻左喉返神经进行手术以避免其损伤时可能会有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07e5/6682338/db14bc744569/cureus-0011-00000004828-i01.jpg

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