【摘要】 目的为甲状腺手术中保护喉上神经外支提供解剖学基础。方法成人尸体32具(64侧),解剖观察喉上神经外支在环甲间隙的解剖学特点,观察该神经与间隙内其他解剖结构的关系。结果3侧喉上神经存在袢状结构;发现所有标本中均存在环甲肌支,71.8%(46侧)存在咽支;按Friedman分型方法进行分型:Ⅰ型占28.1%(18侧)、Ⅱ型占54.7%(35侧)、Ⅲ型占17.2%(11侧)。喉上神经外支入咽下缩肌点位置均位于胸骨甲状肌深面,斜线下方。喉上神经外支入咽下缩肌点至斜线的垂直距离为(3.60±0.30)mm,距胸骨甲状肌内侧缘的垂直距离(8.27±1.72)mm,距环状软骨中点的距离是(27.09±1.46)mm。结论甲状腺手术中,从环甲间隙入路多数情况下可以显露保护喉上神经外支环甲肌支;大于17.2%的情况下不能显露,但也不会损伤。更多还原

【Abstract】 Objective To provide the anatomical basis to protect the lateral branch of the superior laryngeal nerve during the thyroid surgery. Methods 32 Chinese cadavers(64 sides) were dissected to explore anatomic features of the lateral branch of the superior laryngeal nerve(EBSLN) in the avascular space, and observe the close relationship between the LBSLN and other anatomical structures in this space.Result The superior laryngeal nerve loop was observed on 3 sides. On all sides, the EBSLN provided the cricothyroidal branch. The pharyngeal branch was found on 46(71.8%) sides. The Friedman classification was used to define variations in EBSLN. Type 1, type 2 and type 3 accounted for 28.1%(18/64), 54.7%(35/64)and 17.2%(11/64), respectively. The point EBSLN penetrated the inferior constrictor muscle is located under the sternothyroid muscle. The vertical distance between the point where the nerve penetrated the inferior constrictor and slash was(3.60±0.30) mm. The vertical distance between the point where the nerve penetrated the inferior constrictor and the medial margin of sternothyroid muscle was(8.27 ± 1.72) mm. The distance between the point where the nerve penetrated the inferior constrictor and the midpoint of the lower edge of the cricoid cartilage was(27.09 ± 1.46) mm. Conclusion Most of EBSLNs could be exposed and protected by the surgical approach of the potential avascular space. In more than 17.2% cases, EBSLN may not be found,but it will not be damaged.更多还原