CAJ | 학술논문

目的:通过回顾保留副神经的颈淋巴清扫病例中副神经解剖的几种方法,分析总结各种方法的优缺点. 方法:本组15例病例中,3例由胸锁乳突肌前缘分离找到副神经大约需25 min;2例由斜方肌前缘分离找到副神经大约需30 min;10例由胸锁乳突肌后缘分离副神经大约需5 min,有的翻瓣完成后即可隐约看见副神经. 结果:采用胸锁乳突肌前缘分离找到副神经的3例患者,副神经保留完好,术后肩功能影响较小;采用斜方肌前缘分离找到副神经的2例患者中,有1例分离时副神经被切断,术后肩功能恢复较差;采用胸锁乳突肌后缘分离副神经的10例患者,副神经均保留完好,术后肩功能恢复较好. 结论:3种解剖方法中,自胸锁乳突肌后缘分离副神经的方法较简便快捷.
목적:통과회고보류부신경적경림파청소병례중부신경해부적궤충방법,분석총결각충방법적우결점. 방법:본조15례병례중,3례유흉쇄유돌기전연분리조도부신경대약수25 min;2례유사방기전연분리조도부신경대약수30 min;10례유흉쇄유돌기후연분리부신경대약수5 min,유적번판완성후즉가은약간견부신경. 결과:채용흉쇄유돌기전연분리조도부신경적3례환자,부신경보류완호,술후견공능영향교소;채용사방기전연분리조도부신경적2례환자중,유1례분리시부신경피절단,술후견공능회복교차;채용흉쇄유돌기후연분리부신경적10례환자,부신경균보류완호,술후견공능회복교호. 결론:3충해부방법중,자흉쇄유돌기후연분리부신경적방법교간편쾌첩.
Objective:To compare the pros and cons of different surgical techniques on the exposure of accessory nerve in neck dissection. Methods:15 cases with preservation of accessory nerve who underwent neck dissection were retrospec-tively reviewed. 3 kinds of exposure techniques were employed in this review:group A, through the anterior border of ster-nocleidomastoid muscle( 3 cases);group B, through the anterior border of trapezius muscle (2 cases);group C, through the posterior border of sternocleidomastoid muscle ( 10 cases). The advantages and disadvantages between these methods were summarized. Results:It took 25 minutes of operative length in group A, 30 minutes in group B, and 5 minutes in group C. In some cases, accessory nerves could be recognized immediately after exposure of the flap. In group B, the accessory nerves was cut off in one case, the shoulder function was poorly recovered after surgery. Conclusion:Exposure of accesso-ry nerve through the posterior border of sternocleidomastoid muscle during neck dissection was relatively simple and quick.