Applied anatomy of the external laryngeal nerve and superior thyroid artery
ZHONG Yuan, SUN Shan-quan，GONG Rui，ZHANG Wei
Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (3) : 241-244.
Applied anatomy of the external laryngeal nerve and superior thyroid artery
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.
External laryngeal nerve / CSC-ELN loop / Superior thyroidartery / Applied anatomy
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