环甲间隙在腔镜甲状腺手术中的重要意义

doi:10.13418/j.issn.1001-165x.2021.03.018

Abstract

Abstract: Objective　To investigate the significance of the cricothyroid space in protecting external branch of superior laryngeal nerve (EBSLN), recurrent laryngeal nerve (RLN) and parathyroid gland（PT）during scarless in the neck endoscopic thyroidectomy(SET) and the importance of treating upper pole of the gland in endoscopic thyroidectomy.　Methods　A retrospective analysis was performed based on clinical information of 128 cases of scarless in the neck endoscopic thyroidectomy(SET) from April 2014 to July 2018，including unilateral or bilateral subtotal thyroidectomy and unilateral or bilateral partial thyroidectomy. The thyroid gland was partially or completely excised with the operation of upper pole of the gland through cricothyroid space combining the operation of lower pole gland and the outside of the gland.　Results　All the 128 cases were treated with the upper thyroid vessels after entering the cricothyroid space. The EBSLN were exposed in 76 cases (59.3%), the RLN were exposed in 106 cases in the lower thyroid pole at first, and the other 22 cases were exposed by the cricothyroid l thyroid space approach. UPT was found in 106 cases (83%) near the cricothyroid joint and in 22 cases (17%) on the dorsal surface of the upper pole. 84 cases were followed up to now. 2 patients had postoperative hoarseness and unilateral recurrent laryngeal nerve paralysis. There was no voice blunt, no cough when eating and drinking, or no permanent low calcium detected.　Conclusions 　The cricothyroid space plays an important role in safely severing of the superior thyroid vessels and the effectively protecting the EBSLN, the RLN and the upper parathyroid gland（UPT）in endoscopic thyroidectomy. Therefore, the surgical operation on the upper pole of thyroid gland can combine with the operation on thyroid isthmus, the lower pole and the lateral side, to form a routine surgery procedure of the endoscopic thyroid gland, which improves the safety of the operation and facilitates the popularization of the operation.

Key words: Thyroidectomy, 　Endoscopy, 　Cricothyroid space

CLC Number:

R653
R323

Zhang Wanyu, Chen Junxing, Tang Shilong, Lu Qiang, Chen Zhanhui, Chen Rongjun, Qi Songxu, Chen Guixing, Qiu Cheng . Significance of cricothyroid space in endoscopic thyroid surgery [J]. Chinese Journal of Clinical Anatomy, 2021, 39(3): 346-350.

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Significance of cricothyroid space in endoscopic thyroid surgery

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