影响喉次全切除咽环吻合术后喉功能重建的因素分析

Clinical evaluation on the factors associated with the restoration of laryngeal function among the cases undergone cricopharyngeal anastomosis following subtotal laryngectomy

目的 观察喉次全切除咽环吻合术后喉功能重建状况及其影响因素。方法 对27例喉癌患者施以喉次全切除咽环吻合术,保留会厌及环状软骨,构制人工披裂和梨状窝,术后分阶段纤维喉镜录相系统观察。结果27例术后全部重建较理想的喉功能。结论 环状软骨在新喉腔的塑形中起着至关重要的作用,咽缩肌在新喉口发挥了括约功能,术中应避免过多分离损伤。

Objective To evaluate the restorative status and directly associated factors with the restoring process of cases undergone subtotal laryngectorny followed by cricopharyngeae anastomosis. Methods 27 cases with laryngeal carcinoma were included in this study. They were all undergone subtotal laryngectomy followed by cricopharyngeal anastomosis. Here, the epiglotic and cricoid cartiages were reserved to reconstruct the aryepiglottic fold and pyiriform re- cess. During the period of recovering, the local status was evaluated with laryngo-fiberoscope and videotaping system regularly. Results The laryngeal function was reestablished at certain de- grees of ideal among all the patients in this group. Conclusions Cricoid cartilage plays a key role in the formation of new laryngeal cavity and pharyngeal contrictors are very important to play the sphlncter action at the orifice of new larynx. Therefore, it is reasonable to avoid injuring them during the period of surgery.