应用改良胸骨舌骨肌瓣修复喉部分切除术后缺损的远期疗效分析

Long term therapeutic results of vertical partial laryngectomy and reconstruction of modified sternohyoid muscle flap

目的:探讨胸骨舌骨肌瓣应用于喉垂直部分切除术后缺损的修复。方法:对37例T1、T2期声门型喉癌患者行喉垂直部分切除术,术后采用改良胸骨舌骨肌瓣修复喉腔缺损,观察其术后3、5年生存率,拔管率及发音质量。结果:3、5年生存率分别为100%(37/37)、78.4%(27/37),术后拔管率为94.6%(35/37),发音质量良好及中等以上者占100%(37/37)。结论:改良的胸骨舌骨肌瓣避免了全厚肌瓣的臃肿,大小合适,血供好,为修复喉垂直部分切除术后缺损的理想方法。

Objective To evaluate the long term therapeutic effect of vertical partial laryngectomy using reconstruction of modified stemohyoid muscle flap. Methods Thirty seven cases of T1 and T2 glottic cancer and superglottic cancer were treated with vertical partial laryngectomy. The laryngeal defect following partial laryngectomy was repaired with modified stemohyoid muscle flap in the same time. Results After 3-5 years of follow-up, the 3 and 5 years survival rate were 100% and 78.4% respectively. The decannulation rate was 94.6% （35/37）. Vocal quality was good or moderate in all the patients. Conclusion complete resection of tumor and simultaneous preservation of respiratory and vocal function by partial laryngectomy are very important for improving patients life quality. With a suitable size and good blood supply, the modified stemohyoid muscle flap instead of the one with whole thickness is ideal in the reconstruction of laryngeal defect after vertical partial laryngectomy.