杓状软骨的定位研究及其意义

目的为杓状软骨相关手术的术中定位提供解剖数据。方法观测30例60侧正常成人喉标本杓状软骨声带突和肌突形态及其与甲状软骨板的位置关系。结果 (1)测量了顶底间距等10项杓状软骨形态指标,除了甲杓肌附着深度外,其余指标具有性别差异(P0.05)(;2)肌突距甲状软骨下角下端距离:男(13.05±1.92)mm,女(11.76±1.79)mm;距甲状软骨板后缘间距:男(8.11±1.17)mm,女(6.95±1.26)mm;距甲状软骨板内膜间距:男(3.71±1.31)mm,女(3.65±1.23)mm。(3)杓状软骨肌突投影点位于甲状软骨板斜线后下区域,该投影点距甲状软骨下缘距离:男(7.12±1.43)mm,女(5.92±1.26)mm;距后缘距离:男(7.27±1.52)mm,女(5.81±1.47)mm。结论杓状软骨相关手术可根据甲状软骨后缘、下缘、环甲关节下缘来定位肌突。肌突距甲状软骨板内面最近,若从甲状软骨板斜线后区开窗寻找肌突可以缩短手术进路距离。

Localization of arytenoid cartilage and its significance

Objective　To provide anatomic data for the localization of arytenoid cartilage during clinical operation of arytenoid cartilage.　Methods　After dissecting larynx, the locating relationship between arytenoid and thyroid lamina and the morphological features of the projective point of the muscular process in thyroid lamina and vocal process were observed and measured on 30 normal laryngeal specimens (60 sides). Results　(1)10 parameters of arytenoid were measured, including the distance from the top to bottom of arytenoid. Except for the depth of thyroarytenoid attachment in vocal process, the other parameters were gender significant (P<0.05).  (2)The distance from the muscular process to the lower point of the inferior cornu of thyroid was about (13.05±1.92) mm in male and (11.76±1.79) mm in female and to the posterior edge of thyroid lamina was (8.11±1.17) mm in male and (6.95±1.26) mm in female, and to the medial surface of thyroid lamina was 3.71 mm±1.31 in male and (3.65±1.23) mm in female. (3) The projective point of the muscular processes located in the inferior part of posterior oblique line region of thyroid lamina. The point was far from the posterior edge of larynx with the distance of (7.27±1.52)mm in male and (5.81±1.47) mm in female, from the inferior edge of thyroid lamina with the distance of (7.12±1.43)mm in male and (5.92±1.26) mm in female. Conclusions　 Operation about arytenoids may approach along posterior, inferior edge of thyroid cartilage and inferior edge of cricothyroid joint to locate the muscluar process of arytenoid. As shortest is the distance from muscular process of arytenoid to endosteum of thyroid lamina，if we approach from the posterior oblique line region of thyroid lamina to locate the arytenoid in thyroid cartilage windowing operation, the distance of operation should be shortened..