喉上与喉返神经的临床应用解剖学研究

目的　为甲状腺手术避免神经损伤提供应用解剖学资料。方法　解剖观测 12 0例 (左右各 60例 )成人防腐固定标本。结果　喉上神经外支在平甲状软骨上缘与甲状腺侧叶上极上方约 1 2cm处之间 ,两者距离很近 ,其横径为 0 6± 0 2mm。喉返神经与甲状腺下动脉交叉处横径为 1 4± 0 4mm ,其入喉点至环甲关节 (甲状软骨下角尖 )的距离为 5 2± 1 6mm。喉返神经行于甲状腺下动脉前方者右侧稍多于左侧。左侧沿气管食管沟上行 ,右侧与气管食管沟之夹角为 17 8°± 8 2°。结论　喉上神经外支与甲状腺上动脉关系密切 ,喉返神经与甲状腺下动脉呈交叉或交织关系 ,显露神经的术式 ,术中以气管食管沟、甲状软骨下角等为标志 ,是显露喉返神经简便、安全、实用的方法

Clinically applied anatomy of superior laryngeal nerves and recurrent laryngeal nerves

Objectives To provide applied anatomy data to avoid the nerve damage during thyroid operation. Method 120 specimens(60 left and 60 right) of antiseptic adult corpses were examined anatomically.Results Exterior branch of superior laryngeal nerve lies between the upper edge of thyroid cartilage and the superior pole of thyroid lateral lobe, the cross section diameter is 0.6±0.2mm. The diameter of recurrent laryngeal nerve when crossing over with inferior thyroid artery is 1.4±0.4mm. The distance between the points where recurrent laryngeal nerve enters larynx and cricothyroid articulation (the inferior tip of thyroid cartilage) is 5.2±1.6mm. More recurrent laryngeal nerves go infront of inferior thyroid artery in right than in the left. In the left, they go up along the groove between trachea and esophagus. In the right, they form an angle of 17.8±8.2 degrees with the trachea-esophagus groove. Conclusion Exterior branch of superior laryngeal nerve is closely related with superior thyroid artery, while recurrent laryngeal nerve crosses over inferior thyroid artery. In operations that need to expose nerve, using trachea ersophagus groove and thyroid cartilage inferior tip as singns is an easy, safe and practical way to expose recurrent laryngeal nerve.