文章摘要

腔镜甲状腺手术中喉上神经外支监测的应用进展

作者: 1张 姣, 1张 大奇, 1薛 高峰, 1孙 辉
1 吉林大学中日联谊医院 甲状腺外科/吉林省外科转化医学重点实验室/吉林省甲状腺疾病防治工程实验室,吉林 长春130033
通讯: 孙 辉 Email: thyroidjl@163.com
DOI: 10.3978/.2018.05.014
基金: 吉林省财政厅卫生专项基金资助项目(sczsy201714)。

摘要

腔镜甲状腺手术因其空间的制约、能量设备的广泛应用、器械臂间的干扰及不同入路观察视角各异等原因可导致喉上神经外支(EBSLN)可视化程度不足、显露EBSLN时机相对不固定,因此EBSLN保护较开放手术难度大,且常规方法保护EBSLN存在一定局限性。规范化应用术中神经监测技术,既可精准定位,又可提供量化指标,提高手术的安全性。笔者结合国内外报道就腔镜甲状腺手术中EBSLN监测的应用进展作一综述。
关键词: 甲状腺切除术;内窥镜;监测,手术中;喉神经

Application progress of intraoperative neuromonitoring of the external branch of the superior laryngeal nerve during endoscopic thyroid surgery

Authors: 1ZHANG Jiao, 1ZHANG Daqi, 1XUE Gaofeng, 1SUN Hui
1 Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University/Jilin Provincial Key Laboratory of Surgical Translational Medicine/Jilin Provincial Engineering Laboratory of Prevention and Control of Thyroid Diseases, Changchun 130033, China

CorrespondingAuthor:SUN Hui Email: thyroidjl@163.com

Abstract

In endoscopic thyroid surgery, the visualization of the external branch of the superior laryngeal nerve (EBSLN) is insufficient and the time to exposure of the EBSLN is variable, due to the space constraints, application of energy-based devices, interference between the working arms and different perspectives resulted from different approaches. So, the protection of the EBSLN is more difficult than that in open surgery, and furthermore, the conventional methods have several limitations for its protection. The application of intraoperative neuromonitoring technique with standardized process can not only allow precise positioning but also provide quantitative indicators to improve the surgical safety. Here, the authors address the application progress of intraoperative neuromonitoring of the EBSLN during endoscopic thyroid surgery based on a review of literature in China and abroad.
Keywords: Thyroidectomy; Endoscopes; Monitoring Intraoperative; Laryngeal Nerves