喉頭神経損傷に関する手術解剖学的研究

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  • ANATOMICAL RELATION BETWEEN THE RECURRENT LARYNGEAL NERVE AND THE THYROID GLAND
  • 喉頭神経損傷に関する手術解剖学的研究 甲状腺と反回神経との関係について
  • コウトウ シンケイ ソンショウ ニ カンスル シュジュツ カイボウガクテキ ケンキュウ コウジョウセン ト ハン カイ シンケイ ト ノ カンケイ ニ ツイテ

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Fourty-seven adult cadaver larynges with thyroid glands were dissected under a binocular microscope, in order to illustrate the extralaryngeal division of the recurrent laryngeal nerve and its relation to the thyroid gland and the inferior thyroid artery.<br>Results were summarized as followes:<br>(1) The recurrent laryngeal nerves, in all cases except one, were divided prior to arriving the lower margin of the cricopharyngeal muscle where the nerve enteredinto the larynx. A type of two divisions was of and in 67% of examined 94 nerves, three divisions in 27% and four in 5%. In most cases the site of the division was within 1.5cm below the lower margin of the cricopharyngeal muscle.<br>(2) In any type of the nerve division the anterior branch always consisted of motor fibers and the posterior branch was composed of sensory fibers which joined with a branch of the superior laryngeal nerve and composed Galen's anastomosis. When the nerve was divided into three branches, the middle branch was in many cases a motor nerve which innervated the adbuctor muscle, and occationally it was found a sensory one. In cases which the nerve was divided into four branches, the antero-mediate branch was a motor nerve which innervated the abductor muscle and the posteromediate was a sensory one.<br>(3) The recurrent lanryngeal nerve was found to run adjacent to the thyroid gland in 83% of all cases and apart from the gland in only 17%. In most cases the recurrent laryngeal nerve was in the close position to the lower two thirds of the thyroid gland.<br>(4) The recurrent layngeal nerve was situated anteriorly to the inferior thyroid artery in 12% of all cases and posteriorly in 21%. In 67% of cases, the nerve ran between branches of the artery and was drawn nearer to the thyroid gland.

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