[An experimental study on location and clinical application of recurrent laryngeal nerve in vagus nerve].

OBJECTIVE: To locate the recurrent laryngeal nerve fascicles in vagus and investigate the effect of latero-terminal neurorrhaphy to repair recurrent laryngeal nerve. METHOD: The method of dissection and acetylcholinesterase histochemical staining of neural fibers were used to locate the recurrent laryngeal nerve fascicles in vagus. Then 60 SD rats were divided into three groups. In experimental group right recurrent laryngeal nerve were incised and anastomosed to recurrent laryngeal nerve fascicles in vagus by means of latero-terminal neurorrhaphy. In control group right recurrent laryngeal were incised and sutured immediately by means of end-to-end nerve anastomosis. In normal group rats were not treated by any elements. One to three months later, 10 rats from each group were examined for vocal cord movement and nerve regeneration by using fibrolaryngscope and nerve electrormyography. RESULT: The recurrent laryngeal nerve fascicles is in the medial-front segment of the vagus and its diameter is about one-fourth as large as the vagus. One months after operation, This effect of latero-terminal neurorrhaphy had significant difference compared with the control group (P < 0.05). Three months after operation, This effect of latero-terminal neurorrhaphy had not significant difference compared with the control group (P > 0.05). CONCLUSION: The location of the recurrent laryngeal nerve fascicles in vagus provids important anatomical guideline for surgery. The latero-teminal neurorrhaphy has a similiar treatment effect compared with end-to-end nerve anastomosis. This microsurgical technique provides a new method for repairing recurrent laryngeal nerve.