Applied Anagtomy Reserch And Its Clinical Significance Of Laryngeal

Purpose:Through the gross and micro anatomy of the larynx of adult cadaver of China, to investigate the location, shape pattern, variation and close relationship of the larynx main anatomy structure, and to measure some important anatomical marks for surgery, discuss the anatomical significance of various structure in laryngeal surgical procedures, provide the microscopic anatomical data and morphological material for the laryngeal surgery of laryngectomy. laryngea transplants, laryngeal repair, reconstruction surgery, and at the same time to provide fine material for the complete set of larynx anatomy atlas,Method:Simulating the approach of head and neck surgery in thirty-four cadavers, which were processed by 10% formalin, and ten specimens were perfused by red latex. At the first, dissecting the neck according to the anatomical levels of neck, then making the micro anatomy of the larynx, and investigating the location, shape pattern, variation and closeed relationship of the larynx mainly anatomy structures, and shooting by using Nikon D80 digital single lens reflective camera during dissecting.Results:1. Define the detailed origin, shape, location, boundaries, adjacent and so on of the anatomical structures of neck and larynx, and measuring some important structures of larynx.2. The superior laryngeal artery is separated into the anterior-superior branch, the anterior-medial branch, the anterior-inferior branch, the postero-superior branch, the postero-medial branch, the postero-inferior branch. There is more constant for the distribution of the superior artery in intralaryngeal, and more anastomotic branch of the superior artery.3. The internal branch of superior laryngeal nerve is separared into the anterior-superior branch and the postero-inferior branch, besides the anterior-superior branch is divided into the superior branch and anterior branch. There is the Galen's which is formed by the terminal branches of the postero-inferior branch and the posterior branch of the inferior laryngeal nerve.4. The ansa superior laryngeal nerve is considered three kinds of pattern, which is no-ansa kind (21%), singal ansa kind (78%) and double ansa kind (1%).5. The relationships between the inferior thyroid artery and the recurrent laryngeal nerve is more complicated, which is divided five patterns.6. The distance between the point of the inferior laryngeal nerve into larynx and the cornu inferius cartilaginis thyroideae is 5.32±0.77mm, and cricothyroid joint horizontal range is 3.71±0.58mm. The distance between the point of adductor branch of the inferior laryngeal nerve into laryngeal adductor and the inferior tubercle of thyroid cartilage is 5.15±0.45mm. and cricothyroid joint vertical dimension is 7.57±0.45mm, and criocthyroid joint horizontal range is 9.98±0.70mm.7. The shape of epiglottal cartilage is divided into curling pattern 36%), half curling pattern (20%) and flatting pattern (44%).8.There were some variations had been frond. such as one thyrocervical trunk lost; one facial artery, lingual artery and superior artery were origined from the same artery; the external branch of inferior laryngeal nerve crossing the thyroid foramen into larynx; three internal branches of superior laryngeal nerve has directly connected with the posterior branch of inferior laryngeal nerve.Conlusion:1. It is easy to find superior laryngeal artery 14mm in the front of cornu superius cartilaginis thyroideae, and 5mm hypohyal or superior border of thyroid cartilage, which could help location and ligation of superior laryngeal artery during operation.2. The laryngeal artery own much more anastomotic branches, which is the key of the successful implementation of laryngeal reconstruction and partial laryngectomy.3. Cricothyroid artery could be the most important laryngeal nutrient artery instead of the superior laryngeal artery, on which there must be pay more attentions during thyroidectomy, laryngeal reconstruction and partial laryngectomy. 4. There should be expose the detail condition of inferior laryngeal nerve before deligation the inferior thyroid artery for avoiding injury the recurrent laryngeal nerve, because the relationship between the inferior thyroid artery and the recurrent laryngeal nerve is more complicated and variable.5. Internal branch of superior laryngeal nerve may be having the motor function for its branches could contain fibers of sensory nerve.6. The inferior tubercle of thyroid cartilage, cricothyroid joint and lateral border of posterior cricoarytenoid could be the anatomical marks for locating the adductor branch and abductor branch of the inferior laryngeal nerve.7. During the artial laryngectomy, there could retain the postero-inferior branch of internal branch of superior laryngeal nerve under arytenoepiglottic fold 5-10mm, which could retain the sensory function of the mucosal of posterior subglottic region and posterior glottis and arytenoid region for improving the quality of life of the postoperation patient.