喉返神经入喉处的精细解剖学研究

doi:10.13418/j.issn.1001-165x.2021.06.004

中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (6): 642-645.doi: 10.13418/j.issn.1001-165x.2021.06.004

喉返神经入喉处的精细解剖学研究

焦梦思¹，　范宁²，　石玉琦³，　刘得龙³，　佘翠平³

1. 中国人民解放军中部战区总医院，武汉 430070； 2.大连医科大学解剖教研室，辽宁大连 116041
3.大连医科大学附属大连市中心医院耳鼻喉科，辽宁大连 116012

收稿日期:2020-03-27 出版日期:2021-11-25 发布日期:2021-12-01
通讯作者: 佘翠平，主任医师，博士，硕士生导师，E- mail：zxyyscp@163.com
作者简介:焦梦思（1995-），女，湖北咸宁，硕士，主要研究方向：头颈外科方向，E- mail：1509723151@qq.com
基金资助:
大连市医学科学研究计划项目（1911021）

Fine anatomy of recurrent laryngeal nerve entrance into the larynx

Jiao Mengsi¹, Fan Ning², Shi Yuqi³, Liu Delong³, She Cuiping³

1. General Hospital of Central Theatre Command, PLA, Wuhan 430070, China; 2. Department of Anatomy, Dalian Medical University, Dalian 116041, Liaoning Province, China； 3. Department of Otolaryngology, Dalian Central Hospital Affiliated to Dalian Medical University, Dalian 116012, Liaoning Province, China

Received:2020-03-27 Online:2021-11-25 Published:2021-12-01

摘要/Abstract

摘要： 目的　通过对喉返神经(recurrent laryngeal nerve, RLN)入喉处的精细解剖，为临床上甲状腺手术提供有意义的参考标志与数据。方法　40具甲醛固定的男性成人尸体标本，解剖双侧RLN，以同侧气管侧缘与RLN的交点作为角的顶点，记录双侧RLN入喉处与同侧气管侧缘的夹角，双侧RLN入喉处与第1、第2气管环前上缘的垂直距离，与同侧第1、第2气管环侧缘的水平距离。结果　（1）分析双侧RLN入喉处与同侧气管侧缘夹角(α)，0°≤α＜5°的共21例，占26.25%，5°≤α＜10°的共46例，占57.50%，10°≤α＜15°的共11例，占13.75%，α≥15°的仅2例，占2.50%。左侧的夹角为（6.0±0.5）°（0~21°），右侧的夹角为（7.0±0.5）°（0~25°）。(2) 左、右侧RLN距第1气管环前上缘的垂直距离分别为：（19.72±0.52）mm，（21.21±0.43）mm；距第2气管环前上缘的垂直距离分别为（20.91±0.49）mm，（21.42±0.39）mm；距同侧第1气管环侧缘的水平距离分别为：（2.96±0.11）mm，（2.96±0.10）mm；距同侧第2气管环侧缘的水平距离分别为：（3.49±0.12）mm，（3.50±0.52）mm。结论　双侧RLN入喉的角度及在第1、第2气管环的位置较为固定。了解更为精细的RLN入喉处解剖，可在术中更高效且安全的找到RLN入喉处，减少甲状腺手术中对RLN的损伤，从而降低手术并发症的发生率。

关键词: 喉返神经入喉处, 　解剖, 　甲状腺手术, 　夹角, 　气管环

Abstract: Objective　To provide meaningful reference and data for thyroid surgery through the dissetion of the entrance point of laryngeal recurrent nerve (RLN) into the larynx.　Methods　Forty formaldehyde fixed adult male corpse specimens, bilateral RLN were dissected, with ipsilateral cephalic margins of the trachea and the intersection of RLN as the vertex of the angle. The angle between the entry of bilateral RLNs into the larynx and the ipsilateral lateral margin of trachea, the vertical distance between the entry of bilateral RLNs into the larynx and the anterior superior margin of the first and second tracheal ring rings, and the horizontal distance between the entry of bilateral recurrent laryngeal nerves and the lateral margin of the ipsilateral first and second tracheal ring rings were recorded.　Results　 (1) The angle (α) between the throat entrance of bilateral RLN and the side edge of ipsilateral trachea was analyzed. There were 21 cases with 0≤ α <5°, accounting for 26.25%, 46 cases with 5°≤α <10°, accounting for 57.50%, and 11 cases with 10°≤ α <15°, accounting for 13.75 %, 2 cases with α ≥15°, accounting for 2.50 %. The left side angle was (6.0±0.5)°(0~21°), and the right side angle was (7.0±0.5)°(0~25°). (2) The vertical distances from the anterior upper edge of the first tracheal ring to the left RLN and right RLN were (19.72±0.52) mm and (21.21±0.43) mm, respectively. The vertical distances from the anterior upper edge of the second tracheal ring to the left RLN and right RLN were (20.91±0.49) mm and (21.42±0.39) mm, respectively. The horizontal distances from the lateral edge of the ipsilateral first tracheal ring to the left RLN and right RLN were (2.96±0.11) mm and (2.96±0.10) mm, respectively. The horizontal distances from the lateral edge of the second tracheal ring to the left RLN and right RLN on the same side were (3.49±0.12) mm and (3.50±0.52) mm, respectively. Conclusions The entry angle of bilateral RLNs into the larynx and the position of the first and second tracheal rings are relatively fixed. Better understanding of the fine anatomy of the RLN laryngeal entry can help to find the RLN laryngeal entry more efficiently and safely, can reduce the injury of the RLN during thyroid surgery, and thus reduce the incidence of surgical complications.

Key words: Recurrent laryngeal nerve into the larynx, , , Anatomy, , , Thyroid surgery, , , Angle, , , Tracheal ring

中图分类号:

焦梦思, 范宁, 石玉琦, 刘得龙, 佘翠平. 喉返神经入喉处的精细解剖学研究[J]. 中国临床解剖学杂志, 2021, 39(6): 642-645.

Jiao Mengsi, Fan Ning, Shi Yuqi, Liu Delong, She Cuiping. Fine anatomy of recurrent laryngeal nerve entrance into the larynx[J]. Chinese Journal of Clinical Anatomy, 2021, 39(6): 642-645.

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喉返神经入喉处的精细解剖学研究

Fine anatomy of recurrent laryngeal nerve entrance into the larynx

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