声门癌术后会厌喉成形术改良的经验

Ten year experiences of epiglottic laryngoplasty after partial laryngectomy

为客观评价声门癌的会厌喉成形（Ｋａｍｂｉｃ－Ｓｅｄｌａｃｅｋ－Ｔｕｃｋｅｒｍｅｔｈｏｄ，Ｋ－Ｓ－Ｔ）术的远期根治性及功能性效果，总结１００例会厌喉成形术的十年改良经验。改良要点为：①会厌瓣侧缘与环状软骨杓区缝合，形成代杓状软骨，以缩小过大的声门。②另侧会厌上缘和杓会厌襞与声室带断缘缝合，而不与甲状软骨断缘缝合，这样，两侧会厌的游离缘和杓会厌襞尽可能下移达声门水平，以形成代声带。③纵行切开会厌舌面软骨，但保留会厌喉面粘骨膜完整，以形成一锐角的代前连合。３、５、１０年的生存率分别为８７％、７９．５％及６６．７％。认为会厌瓣是理想的喉成形材料。比较新旧两种术式的效果，显示新术式效果比原Ｋ－Ｓ－Ｔ手术好。

In order to objectively evaluate the long term result of epiglottic laryngoplasty (ELP), ten year experience of ELP after partial laryngectomy in 100 patients with glottic cancer was analysed. Our program included ① complete excision of laryngeal carcinoma; ②correct selection of material for laryngoplasty (LP); ③technical modification of LP. The 3,5 and 10 year survival rates were 87%, 79.5% and 66.7% respectively. It is believed that modified ELP is better than original K S T technique in the aspect of preserving all laryngeal functions.