Sasou S, Nakamura S, Kurihara H
Division of Pathology, School of Medicine, Iwate Medical University, Morioka, Japan.
Head Neck. 1998 Dec;20(8):695-8. doi: 10.1002/(sici)1097-0347(199812)20:8<695::aid-hed6>3.0.co;2-3.
It is important to clarify the relationship between the recurrent laryngeal nerve (RLN) and the ligament of Berry to prevent damage to the RLN in thyroid surgery. The purpose of the present paper is to identify this relationship to prevent surgical complications.
Among the 486 thyroid surgery cases, 689 RLNs were identified and their course detected. Topography of the laryngotracheoesophageal region and the histology of the ligament of Berry were studied in detail in 25 autopsied cadavers.
All nerves identified by surgery and autopsy were located laterodorsally to the ligament of Berry. They were clearly separated, and no nerve penetrated the ligament nor was medially located to it. The ligament of Berry strongly connected the thyroid gland to the trachea and was identified as a whitish connective tissue band. No paralysis of the RLN occurred during identification of the nerve during surgery.
It was confirmed that the RLN never penetrates the ligament of Berry but is located laterally to it. From these topographic findings, no injury to the RLN will occur from a separation close to the goiter in thyroid surgery.
明确喉返神经（RLN）与Berry韧带之间的关系对于预防甲状腺手术中喉返神经损伤至关重要。本文旨在明确这种关系以预防手术并发症。
在486例甲状腺手术病例中，识别出689条喉返神经并检测其走行。对25具尸体进行尸检，详细研究喉气管食管区域的局部解剖结构以及Berry韧带的组织学特征。
手术和尸检所识别出的所有神经均位于Berry韧带的背外侧。它们明显分开，没有神经穿过该韧带或位于其内侧。Berry韧带将甲状腺与气管紧密相连，表现为一条白色结缔组织带。手术中识别神经时未发生喉返神经麻痹。
证实喉返神经从不穿过Berry韧带，而是位于其外侧。根据这些局部解剖学发现，甲状腺手术中靠近甲状腺肿进行分离时不会损伤喉返神经。
