School of Medicine, CEU-San-Pablo University, Madrid, Spain.
Department of Anesthesiology, Madrid-Montepríncipe University Hospital, Madrid, Spain.
Clin Anat. 2023 Oct;36(7):1046-1063. doi: 10.1002/ca.24101. Epub 2023 Aug 4.
The aim of this study was to examine the distribution of nerve endings in the mucosa, submucosa, and cartilage of the epiglottis and the vallecula area and to quantify them. The findings could inform the choice of laryngoscope blades for intubation procedures. Fourteen neck slices from seven unembalmed, cryopreserved human cadavers were analyzed. The slices were stained, and cross and longitudinal sections were obtained from each. The nerve endings and cartilage were identified. The primary metrics recorded were the number, area, and circumference of nerve endings located in the mucosa and submucosa of the pharyngeal and laryngeal sides of the epiglottis, epiglottis cartilage, and epiglottic vallecula zone. The length and thickness of the epiglottis and cartilage were also measured. The elastic cartilage of the epiglottis was primarily continuous; however, it contained several fragments. It was covered with dense collagen fibers and surrounded by adipose cells from the pharyngeal and laryngeal submucosa. Nerve endings were found within the submucosa of pharyngeal and laryngeal epiglottis and epiglottic vallecula. There were significantly more nerve endings on the posterior surface of the epiglottis than on the anterior surface. The epiglottic cartilage was twice the length of the epiglottis. The study demonstrated that the distribution of nerve endings in the epiglottis differed significantly between the posterior and anterior sides; there were considerably more in the former. The findings have implications for tracheal intubation and laryngoscope blade selection and design.
本研究旨在探讨会厌及会厌谷黏膜、黏膜下组织和软骨中神经末梢的分布，并对其进行量化。这些发现可能有助于选择用于气管插管程序的喉镜叶片。对来自七个未经防腐、冷冻保存的人体尸体的 14 个颈部切片进行了分析。对切片进行了染色，并从每个切片中获得了横切和纵切面。识别了神经末梢和软骨。记录的主要指标包括位于会厌咽部和喉部、会厌软骨和会厌谷区域的黏膜和黏膜下组织中的神经末梢的数量、面积和周长。还测量了会厌和软骨的长度和厚度。会厌的弹性软骨主要是连续的，但它包含几个片段。它被来自咽和喉黏膜下组织的密集胶原纤维覆盖，并被脂肪细胞包围。神经末梢存在于会厌咽部和会厌谷的黏膜下组织中。会厌的后表面比前表面有更多的神经末梢。会厌软骨的长度是会厌的两倍。该研究表明，神经末梢在会厌中的分布在前后两侧有显著差异；前侧的神经末梢数量明显更多。这些发现对气管插管和喉镜叶片的选择和设计具有重要意义。
