高频超声对正常成人喉咽部解剖结构观察分析

目的　探讨高频超声对正常成人喉咽部解剖结构的显示率及超声表现。方法　对照研究6例离体成人喉咽标本相应断面声像图与组织大切片,并分析喉咽部及其相关结构的超声表现,并对60位（男女各30）正常成人行喉咽部超声扫查,评价各结构的显示率。结果　正常成人梨状窝均可100%完整显示,环后区男、女完整显示率分别为66.7%、93.3%,咽后壁为60%、93.3%,甲状软骨为96.7%、100%,杓状软骨为63.3%、93.3%,环状软骨为60%、96.7%,声带为70%、93.3%,室带为83.3%、96.7%。结论 超声对成年女性喉咽及相关结构显示满意,对成年男性梨状窝和甲状软骨显示较满意,对声-室带显示尚可,对环后区、咽后壁、杓状软骨显示欠佳。     

采用尸体喉标本对成人喉正常超声征象的研究

目的：进行尸体喉部超声影像表现与其解剖-组织学的对比研究,为喉部超声检查提供正常的“参照系”。方法对14例成人尸体颈部标本进行喉部超声扫查,并制作解剖组织学大切片。将超声图像所示“亚结构”的外形与对应的组织大切片进行比较。结果软骨组织构成的甲状软骨、会厌软骨、杓状软骨、环状软骨均呈低回声,软骨膜呈线样强回声。除会厌软骨无骨化外,其余三种软骨均有不同程度的骨化区,呈强回声。声带肌（甲杓内肌）和弹性组织（膜）构成的声带呈对称的三角形低回声结构,其黏膜表面构成的游离缘呈线状偏强回声。主要由疏松结缔组织组成的室带呈对称的类三角形强回声结构。疏松结缔组织构成的会厌前间隙和声门旁间隙表现为偏强回声。结论喉部结构的超声征象取决于它们的解剖组织学基础,通过与组织大切片的对比,明确超声表现与解剖组织学表现的“一对一”关系,从而获得了“正常参照系”。     

喉部超声检查对儿童嗓音疾病诊断的意义北大核心CSCD

目的探讨喉部超声检查对儿童嗓音疾病诊断的意义。方法 2017年1月~2018年1月对以声嘶为主诉的68例儿童(男46例,女22例,年龄4~10岁)行动态喉镜检查和/或喉部超声检查,分析其结果。结果 68例患儿中有62例(91.18%)同时完成了动态喉镜和喉部超声两项检查,6例仅做了喉部超声检查。动态喉镜检查示62例均存在不同程度的声带异常,其中慢性喉炎22例、声带小结19例、声带息肉13例、声带囊肿5例和喉乳头状瘤3例。喉部超声检查呈异常表现的有29例,包括声带小结11例、声带息肉11例、声带囊肿4例和喉乳头状瘤3例,总体检出率为42.65%(29/68)。结论喉部超声检查不能替代喉镜检查,在儿童无法配合或喉镜检查无法明确病变范围时,喉部超声检查可以作为一种辅助和补充检查手段。     

喉部血液供应的解剖学观察

目的为喉部疾病的诊断和治疗提供血供形态学资料.方法解剖观察成年尸体动脉乳胶注标本16具(32侧),分别观察了喉上、下动脉的起始部位、管径、分支及其吻合.结果喉下动脉的起点恒定,均起于甲状腺下动脉;喉上动脉84.4%起于甲状腺上动脉,12.5%起于颈外动脉,3.2%与舌动脉共干.喉上动脉男性平均外径1.7mm±0.23mm,女性平均外径1.5mm±0.17mm;喉下动脉男性平均外径1.1mm±0.18mm,女性平均外径0.9mm±0.14mm;喉上动脉穿入喉的部位84.4%经甲状舌骨膜,9.4%经甲状软骨板;喉上、下动脉之间及左、右两侧之间有广泛的交通吻合.结论喉属多来源血供器官,血供丰富,有良好的侧支循环系统.     

耳鼻咽喉科超声诊断现状与展望

超声诊断是近四十年发展起来的一门新兴学科。由于其对人体无害,操作简便、报告迅速、结果可靠,已在各临床学科广泛应用。本文就其在耳鼻咽喉及头颈外科的应用范围、价值及未来超声诊断的发展作一简介。     

犬喉移植的应用解剖学研究

观察有关犬喉的颈部肌肉，喉的主要供血来源和回流静脉、分析犬喉血液循环的主要通道，测量相关血和的管径，以探讨吻合血管的选择，设计喉再植或移植的血管吻合方式。提出两侧颈总动脉颅甲动脉及颈外静脉的颅喉静脉，喉奇静脉是犬喉血液循环的主要通道，移植时可选择带有颅甲动脉的颈总动脉和两侧的颈外静脉作为吻合血管，单一颅甲动脉可以维持犬喉的血供。     

诊治小儿喉部乳头状瘤3例体会

喉部乳头状瘤患儿，特别是3岁以下的婴幼儿，往往是以声嘶、呼吸困难，甚至是严重的呼吸困难而就诊，如处理不当，易致不良后果。此病复发率高，目前尚无根治办法。现报告我们经治3例小儿喉部乳头状瘤的体会。1病例报告例1女，1岁3个月。2月前因“感冒”后出现声嘶，经多家医院     

超声对特殊部位甲状舌管囊肿的诊断价值

目的探讨超声对于特殊部位甲状舌管囊肿的诊断价值。方法回顾性分析超声图像资料,总结特殊部位甲状舌管囊肿的超声表现并判断超声对病变诊断的准确性。结果 5例位于舌根部,1例位于声门下,超声显示率100%,超声定位准确率100%。超声表现:肿块大小1.1 cm×1.1 cm×1.2 cm～2.4 cm×2.2 cm×1.9 cm;均为类圆形;6例(100%)均为薄壁;4例(67%)内呈无回声,2例(33%)呈均匀低回声;5例(83%)为单房、无分隔,1例(17%)为多房、有细小分隔;后方回声均增强;所有肿块内部及周边均未见血流信号。结论舌根部和喉内甲状舌管囊肿易导致儿童气道梗阻,超声对舌根部和喉内甲状舌管囊肿定位准确,有助于明确病变范围。     

超声扫描检查儿童喉部

除内诊镜外,喉部病变常需辅以放射检查,但因受射线限制及直接喉镜检查增加痛苦,作者等应用电子线性扫描器行实时超声扫描(B超—译註)对89例(男56、女33,2～14岁)喉病(瘢痕性喉狭窄58例、咽狭窄1、先天性喉蹼3、乳头状瘤病5、单侧喉麻痹3、急性缩窄性喉气管支气管炎9、无喉病对照组10例)患儿进行了检查,其结果与喉镜检     

B型超声对喉部肿瘤的诊断价值

Ｂ型超声对喉部肿瘤的诊断价值谭崇才，丁龙垲，龚腾升１９９１年３月至１９９５年６月，我们应用Ｂ型超声诊断仪（Ｂ超）对７２例经临床确诊的喉部肿瘤病人进行检查与诊断，借以探讨Ｂ超对喉部肿瘤的诊断价值。报道如下。１资料与方法１．１临床资料７２例中，男６９例，...     

喉软骨薄层横断面与可视化研究

目的　提供数字化可视人体有关喉软骨横断面的形态学资料和数字化可视模型 ,为影像学诊断及喉外科手术治疗提供形态学依据。方法　从第三军医大学可视化研究组采集的首例中国数字化可视人体数据集中提取会厌软骨上缘至环状软骨下缘的断层图像 ,观察喉软骨的形态结构 ,在SGI工作站上利用面绘制方法对喉软骨进行三维重建和立体显示。结果　断层图像上能清晰显示喉软骨及其骨化区 ,重建结构逼真 ,能展示喉软骨的真实面貌。结论　该数字化可视人体数据集能够较好地重建喉软骨的可视化模型 ,反映喉软骨的形态及其空间毗邻关系。该结果有望应用于喉外科手术的设计和教学。     

The value of ultrasound examination in preoperative neck assessment and in early diagnosis of nodal recurrences in the follow-up of patients operated for laryngeal cancer

The purpose of this study was to prove the superiority of ultrasound (US) examination of the neck in comparison to palpation, to reveal unpalpable nodes (pN0) before surgery, and to allow for the early detection of nodal recurrences in patients with laryngeal cancers. In all, 1,120 patients with laryngeal cancers were operated on between 1990 and 1997. All underwent palpation and neck US before surgery. In the pN0 group US revealed enlarged lymph nodes in 261/505 cases, of which 63 (24.14%) were confirmed as metastatic by histology. All 1,120 patients underwent regular postoperative US follow-up. Nearly 5,000 US examinations were performed; 136 patients who developed nodal recurrences had surgical salvage procedures. In this group 61 patients had small, nonpalpable lesions, and 46 patients discrete and slight changes in scarred necks. In this latter group of 117 patients with nonpalpable lesions, 105 cases were histologically confirmed as metastatic. In postoperative check-ups, metastases were suspected in sonographically detected subclinical nodes, but the US scans obtained were difficult to interpret. In these cases, because of the dynamics of lesion changes, US was repeated two to three times at 10- to 14-day intervals. This reappraisal enabled us to exclude malignancy in regressing nodes, as well as to obtain the stable picture of scar, and support a diagnosis while the lesion grew larger or a central area of low attenuation or hypoechogenic echos appeared in the nodal capsule. Successful radical reoperation for tumor was done on110 patients; 78 patients underwent successful salvage surgery after an early US diagnosis. The sonographic-surgical correlation was nearly 95% and the sonographic-histological correlation was 90%. The follow-up period was 1–49 months. In all preoperative assessments US was found to be a valuable tool in the staging of laryngeal cancer and planning the extent of surgery. Close follow-up with US after radiotherapy and initial operation was essential for the early detection of tumor recurrences, making surgical salvage still feasible. Received: 26 September 1998 / Accepted: 13 April 1999     

Unusual case of laryngeal lipoma

Lipomas are benign tumors, composed of fat cells of the adult type. While lipomas on the trunk and limbs are common, they are rare in the upper aerodigestive tract. Here we report a case of laryngeal lipoma presented with a complaint of change of voice.     

成人喉乳头状瘤的治疗现状

喉乳头状瘤是耳鼻咽喉科最常见的良性肿瘤。近年来,关于成人喉乳头状瘤的治疗方式又有一些新观点。本文就成人喉乳头状瘤的治疗方式做一综述,以便对该病治疗有进一步了解。     

Autofluorescent diagnostics in laryngeal pathology

Autofluorescent diagnostics are based on the ability of oxidized flavin mononucleotide (FMN) in normal cells to emit green fluorescence when exposed to blue light. Neoplastic cells have significantly lower concentrations of FMN and do not emit green fluorescence. Autofluorescent endoscopy is designed for early, accurate and minimally invasive diagnostics for laryngeal pathology. This procedure has the ability to give information about the nature of laryngeal lesions without the devastation of tissue and has important advantages over standard biopsy. In our investigation we used the System of AutoFluorescent Endoscopy (SAFE 1000) designed by Pentax. We examined 38 patients using the SAFE 1000 system, and then all of the patients underwent laryngomicroscopy (LMS). In LMS, a biopsy was taken, and the diagnostic sensitivity of these two methods was compared according to the pathohistologic diagnosis. For statistical evaluation we used Fisher's exact test. We found that autofluorescent endoscopy has greater sensitivity in the detection of precancerous and malignant conditions in the larynx than standard laryngomicroscopy. We believe that autofluorescent endoscopy in addition to laryngomicroscopy gives a more accurate diagnosis of laryngeal pathology than laryngomicroscopy alone.     

Recovery of laryngeal sensation after superior laryngeal nerve anastomosis.

OBJECTIVES/HYPOTHESIS: Reliable motor reinnervation has been show in multiple laryngeal transplant studies; however, sensory reinnervation of the larynx after nerve anastomosis has yet to be demonstrated. The role of sensory nerve anastomosis in the transplanted larynx in unknown, but is thought to be necessary to provide airway protection. A canine model was developed to examine the possibility of reformation of sensory pathways in the larynx after nerve section and anastomosis. STUDY DESIGN: Randomized controlled experiment. METHODS: Ten canines were randomly assigned to two groups. Hydrochloric acid-induced laryngospasm was demonstrated in every dog. All dogs then had their necks explored, and the internal branch of the superior laryngeal nerve was identified and transected bilaterally. Following nerve section all dogs were retested for an acid-induced laryngospasm reflex. The control group had their wounds closed and were then awakened from anesthesia. The study group underwent microscopic anastomosis of their sensory nerves. Following a 6-month period the two groups of dogs were compared for the presence of the laryngospasm reflex. RESULTS: No dog in the control group had a response to the acid. All dogs in the study group had some response to the acid, although none of them had return of true laryngospasm. CONCLUSION: We concluded that sensory reinnervation does occur after nerve anastomosis, but the recovery of sensation may be incomplete or altered.