摘要
目的 明确喉返神经在颈椎前路手术入路中的应用解剖学特征 ,为颈椎前路手术入路提供指导。方法 取成人尸体标本 4 2具 ,在颈动脉鞘与气管食管间找到喉返神经 ,观察脏筋膜结构及其与喉返神经的关系 ,观察并测量右侧喉返神经脏筋膜穿入点与椎体水平的对应位置关系 ,观察并测量右侧喉返神经与颈总动脉内缘交叉点与椎体水平的关系。结果 (1 ) 4 2具标本中 ,脏筋膜均完整存在且能被完整推向对侧。 (2 )右侧喉返神经脏筋膜穿入点在C7T1 椎间盘水平 6例 (1 4 .3% ) ,T1 椎体上半 36例(85 .7% ) ,喉返神经与颈总动脉内缘交叉点在T1 椎体上半 8例 (1 9.0 % ) ,椎体下半 34例 (81 .0 % )。 (3)左侧喉返神经在T2 水平及其以上未见穿入点。结论 (1 )颈部脏筋膜完整存在 ,右侧喉返神经位置相对恒定。 (2 )无论采取左侧或右侧颈椎前侧入路 ,均应在脏筋膜外操作。 (3)行C6,7椎间盘或以上水平的手术采取右侧入路是安全的而且方便的。
Objective To observe the anatomical feature of recurrent laryngeal nerve in anterior cervical approach.Method Forty two adult cadavers were dissected.Recurrent laryngeal nerve were found between carotid sheath laterally and trachea and esophagus medially.The visceral fasciae and its relation to the recurrent laryngeal nerve were observed.The points where the recurrent laryngeal enter the visceral fasciae were found and observed corresponding with vertebral body level.The points where the laryngeal nerve cross the medial margin of common carotid artery were also observed corresponding with vertebral body level.Results (1) Visceral fascia were intact in all of the 42 specimens and can be pulled to the opposite side as a whole encircling trachea and esophagus.In 6(14.3%) specimens the laryngeal nerve′s entry to the visceral fasciae was at the level of C 7T 1 intervertebral disc,and 36(85.7%) specimens at the upper half of T 1 vertebral body.In 8(19.0%) specimens the points where the laryngeal nerve cross the medial margin of common carotid artery were at the level of upper half of T 1 vertebral and 34(81.0%) specimens at the level of lower half of T 1 vertebral.(2) The left laryngeal nerve had no entry to the visceral fasciae at and above the level of T 2 vertebral body.Conclusion (1) The location of the right laryngeal recurrent nerve is roughly constant in neck and the visceral fasciae is intact.(2) No matter which side of approach is employed the operation must be out of visceral fasciae.(3) The right approach is safe and convenient if the operation at or above C 6,7 intervertebral disc,and if the operation is at or below C 7 vertebral body the left approach is appropriate.
出处
《重庆医学》
CAS
CSCD
2004年第1期49-51,共3页
Chongqing medicine
关键词
颈椎
手术入路
喉返神经
筋膜
应用解剖
cervical vertebral
surgical approach
recurrent laryngeal nerve
fasciae
applied anatomy
