Abstract: 【Abstract】 Objective To summarize the experience of routine exposure of recurrent laryngeal nerve (RLN) by different anatomical landmarks. Methods 400 patients with thyroid surgery were includ?lage (group C), and tracheoesophageal groove (group D). Time of RNL exposure, RNL injury (temporary or permanent) were recorded in each group and analyzed. Results Among the groups, the shortest anatomi?cal time of RNL was in group C, the longest in group B, and the amount of bleeding had no significant dif?ferences in 4 groups. Ultrasonic scalpel helped to reduce operative hemorrhage and shorten operation time. Conclusions The way of recurrent laryngeal nerve exposure in thyroid surgery should be based on the surgeon′s preference and performed individualized anatomical way.

Key words: RLN, ultrasonic scalpel, injure, anatomic landmark

摘要： 【摘要】目的 总结甲状腺手术中4种不同解剖标志暴露喉返神经的方法，比较各自的优缺点。方法 分析400例甲状腺手术，依据不同解剖标志显露喉返神经，分为四组：甲状腺体下极（A组），甲状腺下动脉（B组），甲状软骨下角（C组），气管食管旁沟（D组）。对比解剖时间、神经损伤（暂时性和永久性）。结果 C组显露时间最短,B组最长。各组的出血量无明显差异。超声刀有助减少手术出血，缩短手术时间。结论 根据甲状腺的病变特点和手术者的习惯，采取个体化的解剖路径显露喉返神经，有助于减少损伤。

关键词: 超声刀, 损伤 , 喉返神经, 解剖标志