喉癌喉部分切除术的扩展：1．声门上型喉癌──喉水平垂直部分切除术

The extension of conservation Iaryngeal surgery 1.Horizontal vertical(three quarters)Iaryngectomy for supraglottic carcinoma

对７３例声门上喉癌，已侵及声门区（Ｔ２）、杓状软骨已固定（Ｔ３）、已侵及会厌谷（Ｔ４）者，作声门上水平垂直喉部分切除木，用舌骨肌瓣作残喉修复。３年及５年生存率为７５．３％及６８．８％。术后除管率７４．３％，语音清楚可辨者占８２．４％，术后全部经口进食。

Abstract The purpose of conservation laryngectomy is twofold:radical cure ofkryngeal cancer and at the same time preservation of the laryngeal function to the utmost.In recent years many patients who would have been treated by total laryngectomy were survived after par-tial resection,retaining a functional, though somewhat compromised, larynx.From November,1979 to 1991,73 patients were treated by the horizontal veriical(three quariers)laryngectomy an extension of conventional partial resection. Most of the cases(52 patients)were among the T3 category. The crippled larynx was reconstructed with a hyoid bone osteomuscular flap. The three year suvival rate was 75.3%and 5 year,68.8%,The decannulation rate was 74.3%and 82.4%of the patients had a speech with an intellgible voice. All patients resumed normal mouth-food-taking. For supraglottic cancer,the horizontal vertical laryngectomy seems to be the limit of function-sparing laryngectomy for the time being.