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 Posted: Fri 11:28, 25 Mar 2011 Post subject: mbt chaussures paris Non- return of the recurrent |
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Non-return of the recurrent laryngeal nerve in 1 case report
Pedestrians on the side wall jets (Figure 1). No abnormal left recurrent laryngeal nerve exploration, intraoperative dissociation carefully and protect it. No postoperative hoarseness, laryngoscopy showed bilateral vocal cord movement as usual. Figure 1 Non-return of the right recurrent laryngeal nerve (cA: carotid artery; VN: vagus nerve; NIu: non-return of the recurrent laryngeal nerve) 2 discussions generally left and right recurrent laryngeal nerve (recurrentlaryngealnerve, RLN) issued from the vagus nerve respectively, around the aortic arch and right subclavian artery below the trachea, esophagus between the uplink channel, to the inferior pharyngeal constrictor muscle at the lower edge of choking, because the back-line process to be named. Non-return of the recurrent laryngeal nerve is the vagus nerve from the lateral or after the issue of direct choking the recurrent laryngeal nerve with simultaneous confluence choking, is a rare anatomical anomaly. Occasionally a case report of domestic, mostly hoarseness after thyroidectomy and found the second surgical exploration. This case was found in the first operation, Corresponding author: Sun Hui is the more common type J, is wholly non-recurrence of the right recurrent laryngeal nerve. But back to the case of the recurrent laryngeal nerve Africa vagus nerve stem from rampant after the issue of access to the lower pole of the thyroid, and then continue on the pedestrian throat,[link widoczny dla zalogowanych], very rare. Does not appear after a hoarse voice, non-return to the exact nature of the recurrent laryngeal nerve protection. With this case, I understand: ① non-return of the recurrent laryngeal nerve is a rare anatomical anomaly, but should raise awareness. When there is cervical abnormalities (such as the right side of the trachea after the origin of subclavian artery anomalies) should be aware of possible variation of the coexistence of a nerve; not found in the normal anatomical position should be highly suspicious of non-recurrent laryngeal nerve recurrent laryngeal nerve exists the possibility of recurrence Do not be easily cut off the thyroid and the carotid sheath between the vascular cord-like structure, to prevent non-return of the recurrent laryngeal nerve injury. ② thyroid surgery recurrent laryngeal nerve is exposure has been the focus of debate,[link widoczny dla zalogowanych], I think that total thyroidectomy should be performed routinely in the dissociation, first, to avoid variation due to nerve damage caused by the deputy, the second is to ensure the complete removal of the gland. ③ dissociation of the recurrent laryngeal nerve have a certain skill, first of all be familiar with the normal nerve anatomy and common anomalies. Under normal circumstances the adoption of a thyroid artery as a symbol: the recurrent laryngeal nerve in thyroid artery before crossing, located vascular sheath, trachea and thyroid artery within the loose connective tissue between the three; or isthmus path to the tracheoesophageal groove as a symbol: the first cut off the thyroid isthmus, the lateral lobe forward foreign flip,[link widoczny dla zalogowanych], exposing the isthmus plane tracheoesophageal groove,[link widoczny dla zalogowanych], and then close the ditch looking nervous. Under normal circumstances can not be found when the recurrent laryngeal nerve, thyroid cartilage can be taken to find the bottom corner as a symbol: the recurrent laryngeal nerve in thyroid cartilage below the bottom corner at the choking of about 0.5cm, the suspensory ligaments in the thyroid gland (also known as the Berry ligament) on the back outside side rather than through it, Berry is white ligament ligament, connecting the gland and trachea,[link widoczny dla zalogowanych], relatively easy to identify. From here forward below the 1 ~ 2cm, generally found in nerves. This case is successfully using this method. ④ should take into account the recurrent laryngeal nerve identification out of shape, color, diameter, to avoid the lower pole vessels, fiber Cambodia, vagus nerve stem or cervical vagus nerve trunk branch mistaken for recurrent laryngeal nerve abnormalities. Raise awareness of non-return of the recurrent laryngeal nerve, so that the correct exposure of the recurrent laryngeal nerve, the prevention of non-return of the recurrent laryngeal nerve injury, to prevent postoperative hoarseness. 3
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