非返性喉返神经损伤的预防

目的 探讨非返性喉返神经的临床意义。方法 复习4例非返性喉返神经的临床资料并结合相关文献,了解非返性喉返神经的变异类型及甲状腺手术中应注意的事项。结果 湘雅医院2156例甲状腺手术中暴露喉返神经共719条,4例被确认具有非返性喉返神经,占0.56％。其中右侧和左侧各2例。3例因首次手术后声嘶再次手术时证实为非返性喉返神经,1例于首次手术中发现。其中3例为同时伴有返支和非返支的喉返神经,且2支均在入喉前2 cm处汇合。另外1例为不伴有返支的右侧非返性喉返神经。结论 非返性喉返神经属少见变异,在甲状腺手术中容易损伤。充分认识非返性喉返神经及变异类型,有助于预防甲状腺手术时喉返神经损伤。

Non-recurrent laryngeal nerve during thyroid surgery:a report of 4 cases and literature review

Objective To investigate clinical significance of non-recurrent laryngeal nerve. Methods Clinical data from 4 cases of non-recurrent laryngeal nerve and related literature review was made to acknowledge its incidence, variant types and matters concerned during thyroid surgery. Results Seven hundred and nineteen recurrent laryngeal nerves were exposed during 2156 thyroid operations in Xiangya Hospital, from which 4 were confirmed to hold non-recurrent laryngeal nerves (0. 56%). Two cases were found on the right side and the other 2 on the left. Among the 4 cases, 3 (patients) were found to have nonrecurrent laryngeal nerves during reoperation because of voice horse after the first operation. The other one was recognized during the first operation. Conclusions Non-recurrent laryngeal nerve, a rare anomaly, is very vulnerable during thyroid surgery. Knowing the related knowledge of the non-recurrent laryngeal nerve and its types is helpful to avoid its damage during thyroid surgery.