Non-Recurrent Laryngeal Nerve and Concurrent Vascular Variants: A Review.
Non-Recurrent Laryngeal Nerve and Concurrent Vascular Variants: A Review.
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DOI：
10.5644/ama2006-124.230
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发表时间：
2018-11-01
影响因子：
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通讯作者：
Filippou, Dimitrios
中科院分区：
文献类型：
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作者：
Bakalinis, Emmanouil;Makris, Ioannis;Filippou, Dimitrios
目的：回顾喉非返神经（RLN）与血管变异共存的现有资料。方法：在MEDLINE上进行系统的文献检索，检索有关非rln存在和共存血管变异的病例报告、原创文章和综述。结果：从文献检索中，报告了104例确诊血管变异的非rln。更具体地说，97.7% （n=101）的病例涉及右侧非rln， 2.3% （n=3）涉及左侧非rln。最常见的与右侧非rln同时发生的血管变异是异常的右侧锁骨下动脉（97%;n=98）。甲状腺内右颈总动脉1例（0.9%），血管解剖正常2例（1.9%）。此外，所有3例左侧非rln均伴有右侧主动脉弓，其中2例还伴有倒位。结论：大血管变异的存在必须提示外科医生寻找非rln。术中神经监测可提高非rln的检出率。需要进一步的研究来确定非rln围手术期的解剖标志，以保护其免受潜在的伤害。
OBJECTIVE: The purpose of this paper is to review the current data on the coexistence of non-recurrent laryngeal nerve (RLN) and vascular variations.METHODS: A systematic literature search was conducted on MEDLINE for case reports, original articles and reviews regarding the presence of non-RLN and coexisting vascular variants.RESULTS: From the literature search, 104 cases of non-RLN with confirmed vascular variants were reported. More specifically, 97.7% (n=101) of cases involved a right and 2.3% (n=3) a left non-RLN. The most common concurrent vascular variant reported with a right non-RLN was an aberrant right subclavian artery (97%; n=98). One case report (0.9%) of an intrathyroidal right common carotid artery was noted and 2 cases (1.9%) were associated with normal vascular anatomy. Furthermore, all 3 cases of a left non-RLN were associated with a right aortic arch, while 2 of them were also accompanied with situs inversus.CONCLUSIONS: The presence of vascular variations of the great vessels must prompt the surgeon to search for a non-RLN. Intraoperative neuromonitoring increases the detection rate of non-RLN. Further research is required to determine anatomic landmarks for the perioperative identification of a non-RLN, allowing its protection from potential injury.