CAJ | 학술논문

目的探讨甲状腺手术中非肉眼可见喉返神经（RLN）损伤的机制。方法总结吉林大学中日联谊医院应用术中神经监测( IONM)系统发现的非肉眼可见RLN损伤的类型及其保护的经验。结果甲状腺手术中非肉眼可见的RLN损伤机制主要包括：Berry韧带牵拉损伤、肿物牵拉损伤、热损伤、丝线切割伤、吸引器损伤等。发现损伤后给予营养神经、对症处理，患者无永久性声带麻痹发生。结论IONM可以发现非肉眼可见的RLN损伤。通过其机制的研究，可以不断的改进手术技术，降低RLN损伤的几率。
목적 탐토갑상선수술중비육안가견후반신경（RLN）손상적궤제。방법총결길림대학중일련의의원응용술중신경감측( IONM)계통발현적비육안가견RLN손상적류형급기보호적경험。결과갑상선수술중비육안가견적RLN손상궤제주요포괄：Berry인대견랍손상、종물견랍손상、열손상、사선절할상、흡인기손상등。발현손상후급여영양신경、대증처리，환자무영구성성대마비발생。결론IONM가이발현비육안가견적RLN손상。통과기궤제적연구，가이불단적개진수술기술，강저RLN손상적궤솔。
Objective To investigate the mechanism and prevention of invisible injury of recurrent laryngeal nerve (RLN) system in thyroid surgery, with the application of intraoperative neuromonitoring ( IONM ) system. Methods The type of invisible RLN injury and its protection with the application of IONM system were analyzed. Results The causes of invisible RLN injury mainly included stretching of Berry ligament or the tumor,contusion, thermal injury, cutting of silk and suction injury. RLN invisible injury was recoverable through neurotrophic and symptomatic treatment. No permanent vocal cord paralysis occurred. Conclusions With the application of IONM system, some invisible type of RLN injuries can be found. The risk of RLN injury can be reduced if the surgical techniques are improved with the development of study on mechanism of IONM system.