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在开放性甲状腺切除术中保护上喉神经外分支的关键点:一种可能的探索技术
Hang Chen1, Keyi Xu1, Xueying Peng1
1Department of Day Ward, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, China.
Surgical oncology
|March 10, 2024
概括
在甲状腺切除术期间扩大甲状腺-喉三角形显著改善了上喉神经 (EBSLN) 外分支的暴露,减少了语音变化. 这种标准化的方法最大限度地降低了受伤风险,并保证了手术后的声音功能.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术解剖学手术解剖学
- 神经损伤 神经损伤
背景情况:
- 在甲状腺切除术期间,上喉神经 (EBSLN) 的外部分支受伤是术后语音变化的常见原因.
- 经常忽视EBSLN,导致潜在的损伤和患者的发病率.
研究的目的:
- 为了减少甲状腺切除术期间EBSLN损伤的发生率.
- 通过扩大胸甲状腺 - 喉三角形和标准化外科探索来增强EBSLN识别.
主要方法:
- 对520名甲状腺切除术患者进行了回顾性分析.
- 在实施甲状腺-喉三角扩张之前和之后,比较了EBSLN的暴露率.
- 在解剖学上,EBSLN的分类是基于它们与甲状腺-喉三角形 (STP) 的关系.
主要成果:
- 甲状腺喉三角形扩张使EBSLN暴露率从33.7%增加到82.7%.
- 整体EBSLN损伤率显著降低至0.2%,仅报告了一例语音变化.
- 确定了四种EBSLN解剖类型,其中1型 (STP以上的神经,没有血管重叠) 是最常见的55.3%.
结论:
- 扩大甲状腺 - 喉三角形是一种有效的方法,可以在甲状腺切除术期间增加EBSLN可视化.
- 这种技术显著降低了EBSLN损伤和随后的语音损伤的风险.
- 通过三角扩张促进甲状腺上极区域的标准化探索,对于保存声功能至关重要.
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