喉癌切除颈阔肌肌筋膜瓣整复术

LARYNGOPLASTY BY PLATYSMA MYOFASCIAL FLAP AFTER SUBTOTAL LARYNGECTOMY

２５例喉癌切除木后用颈阔肌肌筋膜瓣整复，全部（９２％）或部分恢复了喉功能。手术时根据肿瘤大小与部位行喉部分切除、次全喉或扩大次全喉切除，沿颈浅筋膜层将颈阔肌连同其肌筋膜与皮下组织分开，根据缺损的大小，切制相应的单蒂颈阔肌肌筋膜瓣并转入术腔修补缺损。该法取材方便，制作简单，适用于较大的咽、喉缺损。由于预阔肌筋膜较薄，术后呼吸通畅，发音较好。

A new laryngoplasty by platysma myofascia was repored.An transverse incision was made in the direction of the cervical skin creases at the level of cricoid cartilage.A flap consisting of skin and platysma was elevated supriorly to the hyoid bone and was reflected superiorly, sewn to the upper draps.According to the size and location of tumor, partial, subtotal or enlarged subtotal laryngectomy deseried as Bailey's method had been performed.Then skin flap was pulled and separated between the platysma and superficial fascia.Care should be taken to avoid cutting or tearing the thin platysma muscle.According to the size and shape of laryngeal or pharyngeal defect, a unipedicle platysma myofascia flap was taken and transposed into the lumen to cover the defect.Twenty-five patients with glottis or superglottis cancer had undergone partial, subtotal or enlarged Subtotal laryngectomy reconstructed by platysma myofascial flap.This restoration had provided a competent glottis and obtained a better decannulation rate (92%).