副神经

Purpose To investigate the clinical pathological features of glomus jugulare tumor and to analyze the biological behaviors of paraganglioma.

目的 探讨颈静脉球瘤的临床病理特征和副神经节瘤的生物学行为。

This study showed that the occurrence rate of imaging diagnosis of cranial nerves involvement decreased in sequence:mangibular nerve 18 percent, cavernous sinus 17 percent, hypoglossal nerve13 percent, trigeminal ganglion 10 percent ,(glossopharyngeal nerve, vagus nerve, accessory nerve) 6 percent.

本研究显示受累颅神经的影像诊断发生率依次递减为三叉神经第3支受累18％、海绵窦17％、舌下神经13％、三叉神经半月结10％、舌咽/迷走/副神经6％。

Result :We found that the line from the apes of the mastoid process making for the front margin 4cm(superior 1/4 joint with inferior 3/4)of the sternocleidomastoid muscle to the posterior margin 5cm(superior 1/3 joint with inferior 2/3)is the projective line of the accessory nerve(80%±5%).

结果：见乳突尖向胸锁乳突肌前缘4cm（上1/4下3/4交点）和向下至后缘5cm（上中1/3交点）处连线深面有副神经（80%±5%），该处是切断胸锁乳突肌及其副神经肌支的最佳部位之一。

Results The accessory nerve going through or beneath the sternocleidomastoid muscle occurred in 82%(27/33)and 18%(6/33)of the patients respectively.

结果 82 %(2 7/ 33)副神经穿过胸锁乳突肌，1 8%(6/ 33)在胸锁乳突肌深面行走；85 %(2 8/ 33)副神经和颈神经根间存在吻合交通支；副神经在耳大神经出胸锁乳突肌后缘中点上方 2cm范围内出该肌；70 %(2 3/ 33)副神经在进入斜方肌前约 2～ 3cm基本与该肌前缘平行下行后进入该肌；副神经游离、解剖时间约 2 0～ 30min ；术后病理证实 2 7%(9/ 33)病例颈淋巴结转移。

The aim of the study is to improve the outcomes of shoulder abduction by accessory nerve transfer from the following two aspects:① Select the best choice of recipient nerve;②Design a dorsal-approach spinal accessory nerve transfer, more effevtively use the pinal accessory nerve.

本课题研究旨在从以下两个方面：①选择副神经移位恢复肩关节外展功能的最佳受区神经，②设计新的后入路副神经移位术式；提高副神经的利用效率，改善术后患者肩关节外展功能的恢复。

Results Followed-up for 25~37 months (average 27.5 months), the fisrt signs of reinnerveation of suprascapular nerve appeared at 5~12 months,average 9.94±3.26 months,that of axillary nerve appeared at 9~15months, average12.60±3.08 months;The results in patients with suprascapular nerve as recipient(upper partial 57.08±21.16°, total 40.71±14.27°) were significantly better than that in patients with axillary nerve as recipient(upper partial 31.25±20.97°, total 18.75±7.50°). And the muscular function in upper, middle and lower portions of trapezius are affected due to nerve transfer.

结果 随访25~37个月(平均27.5个月)，来院随访18例；副神经移位修复肩胛上神经术后功能恢复征象最早出现在5~12个月，平均9.94±3.26个月，修复腋神经最早出现在9~15个月，平均12.60±3.08个月；修复肩胛上神经肩外展恢复结果(上臂丛神经损伤57.08±21.16°，全臂丛损伤40.71±14.27°)优于修复腋神经的恢复结果(上臂丛神经损伤31.25±20.97°，全臂丛损伤18.75±7.50°)，P.05；副神经移位后斜方肌各部功能丧失明显。

Radical functional neck dissection were performed and the relations between the accessory nerve and its surrounding structures were recorded.

介绍副神经的寻找及保留方法，记录副神经与周围结构关系、手术时间及术后淋巴结病理检查结果等。

Along its course, accessory nerve gave several branches to trapezius muscle. Conclusions: The course of accessory nerve is constant, which is helpful to protect and find out it during the related procedures.

副神经有较为恒定的标志，上述测量的副神经体表定位有助于在有关手术中可以有效地保护或快速子找副神经。

Part OneA Clinical and Comparative Study on the Choice of Recipient Nerve of the Spinal Accessory Nerve Transfer for Restoration of Shoulder Abduction in Brachial Plexus InjuryObjective To explore the best choice of recipient nerve for spinal accessory nerve transfer for restoration of the shoulder abduction in brachial plexus injury. And, to observe the affection of the trapezius function after operation.

第一部分副神经移位治疗臂丛损伤恢复肩外展功能受区神经选择的临床比较研究目的探讨副神经移位恢复肩关节外展功能最佳受区神经的选择，并同时了解传统锁骨上前入路副神经移位术后斜方肌各部功能的变化。

Radical neck dissection ; Lymphatic metastasis; Head and neck neoplasms; Accessory nerve; Carcinoma; radical neck dissection; accessory nerve; hypopharyngeal carcinoma; quality of life; questionnaire

颈淋巴结清扫术；淋巴转移；副神经；头颈部肿瘤；颈清扫术；副神经；下咽肿瘤；生活质量；问卷

Breath, muscle contraction of the buttocks; arch body, as far as possible to hold his head, right leg straight towards the ceiling (peg-leg knee in order to avoid muscle tension).

呼气，收缩臀部肌肉；拱起身体，尽量抬起头来，右腿伸直朝向天花板（膝微屈，以避免肌肉紧张）。

The cost of moving grain food products was unchanged from May, but year over year are up 8%.

粮食产品的运输费用与5月份相比没有变化，但却比去年同期高8％。