Recurrent bronchogenic cyst causing recurrent laryngeal nerve palsy.

A case of a 50-year-old male who developed left recurrent laryngeal nerve palsy due to a bronchogenic cyst is presented. The bronchogenic cyst recurred following incomplete excision and multiple attempts at percutaneous aspiration. Recurrent laryngeal nerve palsy is an unusual complication of bronchogenic cysts. This case highlights the need for complete excision of these cysts and the lack of efficacy of cyst aspiration.     

甲状腺手术中常规显露喉返神经的意义

目的 探讨甲状腺手术中常规显露喉返神经(RLN)对保护神经的作用.方法 回顾性分析2009年至2010年间连续实施的232例甲状腺切除手术患者的资料.手术均由同一组医师实施,方式为甲状腺腺叶切除或全切除术,术中常规显露喉返神经.结果 共行腺叶切除181例,甲状腺全切除51例.术中解剖喉返神经280根(98.9%).术后...     

甲状腺手术中常规显露喉返神经的意义

目的 探讨甲状腺手术中常规显露喉返神经(RLN)对保护神经的作用.方法 回顾性分析2009年至2010年间连续实施的232例甲状腺切除手术患者的资料.手术均由同一组医师实施,方式为甲状腺腺叶切除或全切除术,术中常规显露喉返神经.结果 共行腺叶切除181例,甲状腺全切除51例.术中解剖喉返神经280根(98.9%).术后10例患者(3.6%)出现声音嘶哑,其中7例术中证实了喉返神经的完整性,但声带检查出现患侧运动障碍,均在术后2个月内发音恢复正常.另外3例为术中离断性神经损伤并行即刻吻合者,在术后4个月内声音均恢复正常.结论 甲状腺手术中常规显露喉返神经是预防喉返神经永久性损伤的有效方法.     

Voice changes after thyroidectomy without recurrent laryngeal nerve injury

BACKGROUND: Injury of the inferior laryngeal nerve is not the only cause of voice alteration after thyroidectomy; many patients notice minimal changes immediately after operation, without evidence of inferior laryngeal nerve damage. We hypothesized that there may be other causes for voice modification, such as injuries of the superior laryngeal nerve, prethyroid strap muscles, and cricothyroid muscles. We describe voice changes after total thyroidectomy, without inferior laryngeal nerve injury, using a computer program to objectively compare different patterns of voice. STUDY DESIGN: Forty-six consecutive patients who underwent total thyroidectomy were studied between March 1997 and December 1999. Acoustic voice analysis was performed preoperatively and at the second, fourth, and sixth postoperative months using a microphone adapted to a personal computer. Parameters measured were intensity of the voice (Shimmer) and fundamental frequency (Fo). RESULTS: No complications occurred during operation or in the postoperative period. Voice fatigue during phonation was the most common symptom after thyroidectomy. Forty patients (87%) stated that their voices had changed since the operation, and common complaints were voice alteration while speaking loudly, changes in voice pitch, and voice disorder while singing. Changes in the Fo and Shimmer values in smokers versus nonsmokers were similar (Fo overall, p = 0.56; Shimmer overall, p = 0.66), as were the same parameters in benign and malignant pathologies (Fo overall, p = 0.66; Shimmer overall, p = 0.67). CONCLUSIONS: Voice changes after uncomplicated thyroidectomy occur and can be objectively measured. This is important in the preoperative counseling of patients before thyroidectomy, for ethical and legal purposes.     

甲状腺手术中解剖喉返神经的临床研究

目的探讨甲状腺手术中解剖喉返神经对防止喉返神经损伤的价值。方法回顾性分析783例甲状腺手术患者的临床资料,术中解剖喉返神经405例（解剖组）,不解剖喉返神经378例（不解剖组）,观察术后两组喉返神经损伤情况。结果解剖喉返神经组喉返神经暂时性损伤2例,损伤率0.49%,无永久性损伤病例。不解剖喉返神经组喉返神经损伤11例,损伤率2.91%,其中永久性损伤6例,暂时性损伤5例。两组间差异有统计学意义（P〈0.01）。结论甲状腺手术中解剖喉返神经能显著减少喉返神经的损伤,是预防其损伤的有效方法。     

甲状腺手术中喉返神经保护研究进展

喉返神经损伤是甲状腺手术中常见的并发症之一.随着超声刀、术中神经监测、腔镜甲状腺切除术、精细化解剖技术等设备仪器和治疗理念的广泛推广,在甲状腺手术方式发生巨大改变的同时,术中保护喉返神经也面临新的问题.熟悉喉返神经的解剖特点,掌握新技术、新器械、新仪器的使用技巧,是在新技术和新理念应用中保护喉返神经的关键.     

Recurrent laryngeal nerve palsy associated with mediastinal amyloidosis

Amyloidosis affecting peripheral nerves causing isolated nerve palsies is uncommon. Localised amyloidosis occurs less frequently than the reactive or immune related systemic forms, and mediastinal localisation is virtually unknown. We present a case of recurrent laryngeal nerve palsy associated with mediastinal AL amyloidosis in a middle aged man.     

甲状腺腺叶切除术中喉返神经的保护

目的 探讨甲状腺腺叶切除术的技术改进对于喉返神经的保护作用.方法 回顾性分析2010年1月至2011年1月85例接受改良甲状腺腺叶切除术患者的临床资料.结果 本组病例均实现清晰术野,共解剖出喉返神经126条,共出现2例单侧喉返神经一过性损伤,损伤率为1.59％(2/126),无双侧喉返神经损伤,无永久性喉返神经损伤.结论 通过改进甲状腺腺叶切除技术,实施精确甲状腺腺叶切除术可降低喉返神经损伤发生率.