中国耳鼻咽喉头颈外科2017，Vol.24Issue(2)：59-62,4.DOI:10.16066/j.1672-7002.2017.02.002
术前伴喉返神经麻痹的甲状腺肿瘤的临床病理分析
Clinicopathological analysis of thyroid nodules with preoperative recurrent laryngeal nerve palsy
摘要
Abstract
OBJECTIVE To investigate the clinical significance of preoperative recurrent laryngeal nerve palsy (RLNP) for thyroid nodules with regard to the incidence of malignancy,recurrent laryngeal nerve involvement and histopathological character.METHODS Eighty patients with preoperative RLNP treated in Zhejiang Cancer Hospital between Jan 2007 to Dec 2014 were enrolled,their clinicopathological data were recorded and retrospectively analyzed.RESULTS Of 80 patients,16 patients had benign thyroid disease,while the other 64 had malignancies (80.0％).The preoperative RLNP incidence of benign and malignant lesions was 0.3％ and 0.9％ respectively.Poorly differentiated and anaplastic thyroid cancer had the higher incidence of preoperative RLNP comparing with other pathology types (25.93％,P＜0.05).The RLN did not preserved intraoperatively in 2 patients with benign lesions (2/16,12.5％) and in 42 patients with malignancy lesions (42/48,87.50％).All nerves were sacrificed in poorly differentiated and anaplastic thyroid cancer patients.The RLN could be isolated from 14 benign lesions and 6 malignancies,with or without adhesion,and the nerve function was recovered postoperatively.CONCLUSION The probability of preoperative RLNP is significantly higher in malignant lesions than benign lesions.Thyroid tumors with RLNP are strongly suggested of malignancy,with higher rate of intraoperative nerve sacrifice.The RLN should be preserved if it has not been invaded by the tumor,which offers a chance of functional recovery postoperatively.关键词
甲状腺肿瘤/腺癌,乳头状/甲状腺肿,结节性/甲状腺切除术/喉返神经麻痹Key words
Thyroid Neoplasms/Adenocarcinoma, Papillary/Goiter, Nodular/Thyroidectomy/recurrent laryngeal nerve palsy引用本文复制引用
韩春,郑伟慧,王可敬,郭良..术前伴喉返神经麻痹的甲状腺肿瘤的临床病理分析[J].中国耳鼻咽喉头颈外科,2017,24(2):59-62,4.基金项目
浙江省科技厅公益技术研究社会发展项目(2015C33211)和浙江省医药卫生科技计划资助项目(2015KYB065)联合资助 （2015C33211）
