摘要
目的观察支撑喉镜下环咽肌形态。方法采用普通支撑喉镜系统，观察因咽喉部疾病需做喉显微外科手术且无吞咽困难主诉的患者100例。气管插管全身麻醉，同时使用肌肉松弛药物，喉镜由环后插入，将喉向前抬起，暴露环咽肌。图像采集系统记录环咽肌图像。结果94例患者环咽肌得到良好暴露，6例因颈椎僵硬或肥胖未能暴露。观察发现支撑喉镜下环咽肌形态分为3型：即下咽后壁无明显隆起，可见整个食管腔的平坦型，下咽后壁黏膜槛突向前方，可见部分食管腔的半槛型，以及下咽后壁凸起接近食管入口前壁，食管窥不见的全槛型。各型例数分别是平坦型14例（14．9％），半槛型59例（62．8％），全槛型21例（22．3％）。成年组90例和I〉65岁老年组10例患者环咽肌类型差异经卡方检验差异无统计学意义（x2=1．224，P=0．747）。反流有关组和反流无关组间环咽肌类型差异也无统计学意义（x。=5．252，P=0.072）。结论支撑喉镜能够很好地暴露大多数患者的环咽肌，为开展内镜下环咽肌切断术提供了实践基础。
Objective To observe the morphologic features of cricopharyngeal muscle（CPM） under suspension laryngeal endoscope. Methods This prospective study was conducted on a series of 100 consecutive patients who undergone endoscopic microlaryngeal surgery with intubation general anesthesia. The suspension laryngoscope was introduced down to postcricoid area approaching esophageal inlet. By lifting the larynx with the laryngoscope, the mucosa-covered cricopharyngeal muscle was easily identified as the mound of tissue just at the posterior pharyngeal wall. The image of cricopharyngeal muscle under the laryngoscope was saved. Results In 94 out of 100 patients, CPM could be visualized with laryngoscope. In the other 6 patients, both CPM and glottic could not be exposed because of cervical vertebra stiffness and obesity. According to the image of CPM under the laryngoscope, the shape of the CPM was divided into three types. It was named for flat type in which there was no mound of tissue visible at the posterior pharyngeal wall and esophageal cavity could be visible completely;~ semi-bar type in which there was a bar at the posterior pharyngeal wall and partial esophageal cavity could be visible and full-bar type in which the bar contact esophageal anterior wall and esophageal cavity could not be visible. There were 14（ 14. 9% ） patients as flat type, 59（62. 8% ） as semi-bar type and 21（22. 3% ） as full-bar type. No significant difference was found between adults group and the aged （ ≥ 65 years old） group （ x2 = 1. 224, P = 0. 747 ） and reflux associated group and non-reflux associated group respectively （x2 = 5. 252, P = 0. 072）. Conclusions The CPM could be well exposed in most of the patients with suspension laryngeal endoscope. It provides anatomy basis for endoscopic cricopharyngeal myotomy.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2012年第11期904-907,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
咽肌
喉镜检查
Pharyngeal muscles
Laryngoscopy
