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喉上神经外支走行变异及其在外科手术中的意义:一项尸体解剖实验研究。

Variations in the course of the externalbranch of the superior laryngeal nerveand their importance in surgicalprocedures: an experimental cadaveric study.

机构信息

Department of Anatomy, Istanbul Health and Technology University, Istanbul, Turkey.

Department of Ear Nose Throat, School of Medicine, Istanbul Aydın University, Istanbul, Turkey.

出版信息

Otolaryngol Pol. 2023 Jan 14;77(2):24-29. doi: 10.5604/01.3001.0016.2167.

Abstract

<br><b>Introduction:</b> Injury of the external branch of the superior laryngeal nerve can cause a hoarse or weak voice due to the functional loss (dysergia) of the cricothyroid muscle. Defining the anatomical variations of the external branch of the superior laryngeal nerve and estimating their frequency are crucial for surgical interventions.</br> <br><b>Aim:</b> To reveal the topography of the external branch in the Anatolian population, to prevent injury of it during the surgical intervention in the anterior neck region.</br> <br><b>Material and methods:</b> 26 bilateral hemilarynges (4 females, 22 males) were dissected. The morphometric and morphological features of the external branch were examined. The obtained results were compared statistically, left and right.</br> <br><b>Results:</b> Landmarks such as the thyroid gland and laryngeal prominence were determined for the detection of the external branch. The variations of the course of the external branch and the points of piercing the cricothyroid muscle or inferior pharyngeal constrictor muscle were evaluated.</br> <br><b>Discussion:</b> Although safe approaches have been described for nerve protection during neck surgeries, injuries may occur during preliminary surgery as the mentioned nerve is thinner and more superficial than other branches of the vagus nerve. However, it can be detected more easily and safely by knowing the defined anatomical landmarks and morphological variations of the external branch.</br> <br><b>Conclusion:</b> The anatomical variations described can be a safe and important guide in surgeries of the anterior neck region.</br&gt.

摘要

引言:喉上神经外支损伤可导致环甲肌功能丧失(协同失调),引起声音嘶哑或无力。因此,明确喉上神经外支的解剖变异,并估计其发生频率对于外科手术干预至关重要。



目的:揭示安纳托利亚人群喉上神经外支的局部解剖,以防止在颈部前侧手术中损伤该神经。



材料和方法:对 26 对双侧半喉(4 名女性,22 名男性)进行解剖。检查了喉上神经外支的形态和形态学特征。对获得的结果进行了左右两侧的统计学比较。



结果:确定了甲状腺和喉结等标志,以便于检测喉上神经外支。评估了喉上神经外支的走行变异以及穿入环甲肌或下咽缩肌的部位。



讨论:尽管已经描述了在颈部手术中保护神经的安全方法,但在初步手术中仍可能发生损伤,因为该神经比迷走神经的其他分支更细、更浅。然而,通过了解定义明确的解剖学标志和喉上神经外支的形态学变异,可以更安全、更容易地检测到该神经。



结论:描述的解剖变异可作为颈部前侧手术中安全且重要的指南。

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