喉神经分布与新喉再造术的相关研究  

RELATIVE RESEARCH:INNERVATION AND NEOLARYNX RECONSTRUCTION

作　　者：陈文文[1] 黄鹤年[1] 

机构地区：[1]上海医科大学眼耳鼻喉科医院,上海第四人民医院

出　　处：《上海医科大学学报》1996年第1期3-6,共4页Journal of Fudan University(Medical Science)

摘　　要：研究喉的神经分布与新喉再造术的设计。采用显微解剖、石蜡切片、光镜观察和Ｓｉｈｌｅｒ氏染色法。结果：①喉上神经支配环甲肌的分支有一种变异。不一定是＂外支＂去支配，也可以是内支主干分支后再穿出甲状软骨孔后分布于该肌；②喉返神经的后支与喉上神经内支的分支形成Ｇａｌｅｎ＇ｓ吻合是确实存在的，位于食管前壁粘膜下的结缔组织内，分出分支到食管粘膜，是一种感觉神经，司感觉的部位是食管，而不是声门下区；③可清晰地看到喉内肌的神经分布；④在喉神经充分显示基础上，结合新喉再造术切除范围的设计，分析了能保护两神经主干的最大切除范围─－＂Ｍ＂线。结论：作喉前位切除时Ｍ线是保护神经主干功能的最大切除范围。PURPOSE To study interrelation: innervation of the larynx and design of the neolarynx reconstruction.METHODS Sihler's staining technique and microscopic disection of eleven human larynges.RESULTS ①Some specimens of superior laryngeal nerve(SLN) external branch had a variation: it crossed a hole of thyroid cartilage into cricothyroid muscle. ②The reccurent laryngeal never(RLN) and SLN were connected by Galen's anastomosis in sub-mucosa of esophageal frontal wall. The anastomosis was a sensory branch, but it did not connect with subglottic mucosa.③ The nerve branches could found in muscles of the specimens that had been stained by Sihler's method. ④ As all laryngeal nerves were showed, a straight line that was RLN and SLN entering larynx and its location was bordered on post 1/4 and front 3/4 thyroid cartilage was identified could be named 'M'line (maxunum's abbreviation).CONCLUSIONS ①Sihler's staining is a good method for showing nerves, especially in muscls. ②'M' line is a maximum cutted off range if a consevative laryngectomy is considered.

关 键 词：喉神经分布 喉切除 喉重建 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学] R767.91[医药卫生—基础医学]