The Fiber Arrangement of the Human Recurrent Laryngeal Nerve:A Scanning Electron Microscopy (SEM) Study

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The fiber arrangement of the normal left-sided recurrent laryngeal nerve at the level of second to eighth tracheal cartilage was examined mainly by SEM after the removal of connective tissue components of surrounding the nerve fibers. Formalin-fixed specimens were taken by autopsy from eight individuals, then refixed with glutaraldehyde, hydrolyzed with hydrochloric acid (HCl), digested with collagenase, and processed for SEM observation.Extracellular materials such as fibroblasts and collagen fibers were completely digested, and each nerve fiber was exposed and clearly visible under the SEM. The nerve bundles were composed of parallel running and slightly wavy fibers which practically lacked anastomosis. Fibers with Ranvier's nodes were occasionally observed and definitely identified as the myelinated type. However, its accurate ratio in the recurrent nerve was not yet determined in the present study.By means of SEM in combination with the digestion method (Evan et al., 1975), it was quite easy to obtain the precise stereoscopic image of the course and arrangement of the normal human recurrent laryngeal nerve fibers. This method will be useful to detect pathological changes, such as post-paralytic, misdirected innervation, and neurinoma.
特定非営利活動法人日本気管食道科学会の論文