喉上神经外支和甲状腺上动脉的应用解剖

doi:10.13418/j.issn.1001-165x.2016.03.001

中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (3): 241-244.doi: 10.13418/j.issn.1001-165x.2016.03.001

• 应用解剖 • 下一篇

喉上神经外支和甲状腺上动脉的应用解剖

钟源¹，　孙善全¹，　龚睿²，　张威²

1.重庆医科大学实验教学管理中心人体大体形态学实验室；　2.重庆医科大学基础医学院，重庆 400016

收稿日期:2015-10-20 出版日期:2016-05-25 发布日期:2016-06-17
通讯作者: 孙善全，教授，博士生导师，Tel：13368222455, Email: sunsq2125@sohu.com
作者简介:钟源（1984-），男，四川自贡人，助理实验师，主要从事人体解剖学研究，Tel：13650564272，E-mail：zhongyuan211@sina.com

Applied anatomy of the external laryngeal nerve and superior thyroid artery

ZHONG Yuan¹, SUN Shan-quan¹，GONG Rui²，ZHANG Wei²

1. Laboratory of General Mrophology, Experimental Teaching Management Center, Chongqing Medical University, Chongqing 400016, China; 2. College of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China

Received:2015-10-20 Online:2016-05-25 Published:2016-06-17

摘要/Abstract

摘要：

目的　解剖并观察喉上神经外支（external laryngeal nerve， ELN）和甲状腺上动脉（superior thyroid artery，STA）之间的比邻关系，为手术中保护ELN提供解剖学基础。方法　成年尸体标本57具（114侧），在6倍大视场显微镜下解剖并观察ELN、STA的比邻关系。结果　本组标本中颈交感链（cervical sympathetic chain，CSC)与ELN吻合成袢（CSC-ELN loop)者，占78.9% （90侧）。在27.7%（25侧）低位CSC-ELN loop中，血管和神经的位置关系可分为4类：①STA分支与CSC-ELN loop重叠；②STA腺支穿过CSC-ELN loop；③CSC-ELN loop环甲肌支与STA喉支伴行；④STA的分支与CSC-ELN loop分支相互交叉。结论　STA与CSC-ELN loop之间的关系十分复杂。有鉴于此，在甲状腺和/或颈部手术中，我们特提出两个手术保护措施：①应单支游离并结扎STA；②在处理STA的前内侧分支时，应注意避免损伤ELN/CSC-ELN loop的环甲肌支。

关键词: 喉上神经外支, 喉上神经袢, 甲状腺上动脉, 应用解剖

Abstract:

Objective　The topographic relationship between the external laryngeal nerve(ELN) and the superior thyroid artery (STA) were observed, in order to provide the anatomical foundations for protecting the ELN during surgery.　Methods　 Fifty-seven cadavers (114 sides) fixed with formalin were collected at random. The ELN and STA were carefully dissected and analyzed under a 6-power magnifier.　Results　The cervical sympathetic chain (CSC) of 90 sides was anastomosed with the ELN（CSC-ELN loop). For the 27.7% (25 sides) low-position CSC-ELN loops observed, the neurovascular relationship between the STA and ELN was classified into four types: ①the branches of the STA overlapped with the CSC-ELN loop; ② the glandular branch of the STA passed through the CSC-ELN loop; ③the muscular branch of the CSC-ELN loop and the laryngeal branch of the STA coursed together;④the branches of the STA and the CSC-ELN loop were interlaced.　Conclusion　Our study has shown a variable morphology of the CSC-ELN loop and its complicated topographic relationship to the STA, which should be kept in mind when attempting to avoid the nerve injury. Two special surgical procedures are recommended. First, the vessels should be individually isolated and then ligated during thyroidectomy. Second, a special attention should be paid to protect the coricothyroid branch of CSC-ELN loop from injury, when the anteriomedial branches of the STA are to be ligated during larynx surgery.

Key words: External laryngeal nerve, CSC-ELN loop, Superior thyroidartery, Applied anatomy

钟源,孙善全,龚睿,张威. 喉上神经外支和甲状腺上动脉的应用解剖[J]. 中国临床解剖学杂志, 2016, 34(3): 241-244.

ZHONG Yuan, SUN Shan-quan，GONG Rui，ZHANG Wei. Applied anatomy of the external laryngeal nerve and superior thyroid artery[J]. Chinese Journal Of Clinical Anatomy, 2016, 34(3): 241-244.

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喉上神经外支和甲状腺上动脉的应用解剖

Applied anatomy of the external laryngeal nerve and superior thyroid artery

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