喉功能保留外科相关的喉功能解剖  

The Laryngeal Anatomic Study of Partial Laryngectomy

作　　者：温树信[1] 秦江波[2] 王斌全[1] 张春明[1] 高伟[1] 陈钢钢[1] 董振[1] 

机构地区：[1]山西医科大学第一医院耳鼻咽喉头颈外科耳鼻咽喉头颈肿瘤山西省重点实验室,太原030001 [2]长治医学院附属和平医院耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2016年第1期31-34,共4页Journal of Audiology and Speech Pathology

摘　　要：目的了解喉功能的解剖学基础,为喉癌、下咽癌手术保留喉功能提供解剖依据。方法对4例成年男性尸体喉部的环杓关节相关肌肉、神经及血管进行解剖观察,根据肌肉的起止点与肌纤维方向分析各肌肉的作用。结果甲杓肌位于喉腔内,环杓后肌、环杓侧肌、杓横肌及杓斜肌位于喉软骨支架的后外周面;在相关肌肉的作用下,以环杓关节面为核心,杓状软骨可以完成旋转与滑动运动;环杓后肌与环杓侧肌可以开大、缩小声门,对保证正常的喉功能有更重要的作用;喉返神经于气管食管沟内自下而上支配环杓后肌、环杓侧肌、杓横机、杓斜肌及甲杓肌等肌肉;喉下动脉自甲状腺下动脉发出后走行于环杓后肌的背侧,供血于环杓关节相关组织。结论一侧完整的环杓关节及功能正常的环杓后肌与环杓侧肌是保留喉功能喉部分切除术的最基本条件。Objective To understand of laryngeal anatomic framework;and to provide anatomical evidence for the patients with laryngeal and hypopharyngeal cancers to be performed laryngectomies and preserved laryngeal functions.Methods Four specimens of larynx were taken from 4cases of adult male cadavers of China.Recurrent laryngeal nerves,inferior laryngeal arteries,the positions and enthuses of the muscles closely related to the cricoarytenoid joint were dissected and studied.The functions of those muscles were analyzed.Results The cricoarytenoid joint played a very important role in the courses of phonation,respiration and deglutition.Comparing to thyroarytenoid muscle and arytenoideus,posterior cricoarytenold muscle and lateral cricoarytenold muscle had more important contributions to cricoarytenoid joint action.The posterior cricoarytenold muscle was in the back of cricoid lamina;the lateral cricoarytenold muscle was located at the postero-lateral larynx.The recurrent laryngeal nerve innervating the intralaryngeal muscles and the inferior laryngeal artery supplying inferior laryngeal structures were likely going in the Tracheoesophageal groove,and enteed the laryngeal cavity behind the cricoarytenoid joint.ConclusionThe complete cricoarytenoid joint and the posterior and lateral cricoarytenold muscles with normal functions are the basic conditions when the patients with laryngeal cancers to be performed partial laryngectomies.

关 键 词：喉 尸体解剖 环杓关节 喉功能 喉部分切除术 

分 类 号：R322.32[医药卫生—人体解剖和组织胚胎学]