单侧声带麻痹颈袢-喉返神经吻合修复术的研究进展

Research progress on ansa cervicalis to recurrent laryngeal nerve reinnervation for unilateral vocal fold paralysis

宿玉;郑宏良;王伟;高颖娜

1:海军军医大学第一附属医院耳鼻咽喉头颈外科

摘要
颈袢-喉返神经吻合修复术是用于实现单侧声带麻痹(unilateral vocal fold paralysis, UVFP)患者喉内肌神经再支配、改善嗓音生理功能的神经转位技术,具备坚实的神经再生理论基础,临床疗效确切,但在喉内肌神经再支配的机制阐释、不同颈袢神经转位修复术式的优化选择及基于多种因素影响下的适应证精准界定方面仍有深入研究空间。本文从喉返神经损伤后的瓦勒变性、轴突再生、神经营养因子调控及神经错向再生等方面,阐述喉返神经损伤修复的病理生理基础;结合颈袢与喉返神经的解剖毗邻关系、不同颈袢神经的神经纤维数量特点,以及颈袢神经与发声、吞咽活动相关的同步放电特性,分析该术式的解剖学与神经生理学依据;并梳理其从颈袢分支、主支应用到颈袢前根吻合、对侧颈袢转位及游离神经桥接等技术进展过程;同时,总结病因、年龄、失神经病程、损伤部位、损伤程度及术式选择等因素对术后疗效的影响,以期为UVFP患者外科治疗策略的制定提供理论依据。
关键词
单侧声带麻痹;颈袢神经;喉返神经;神经修复
基金项目(Foundation):
国家自然科学基金面上项目(82571297)
作者
宿玉;郑宏良;王伟;高颖娜
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