双蒂肌软骨膜瓣在垂直半喉切除术中的应用

Application of Bipedicle Muscle and Perichondrial Flap in the Vertical Partial Laryngectomy

目的探讨双蒂肌软骨膜瓣在声门型喉癌垂直半喉切除术中的应用。方法对23例声门型喉癌(T_18例,T_2 15例)行垂直或超垂直半喉切除术,以双蒂肌软骨膜瓣作喉功能重建术。结果 23例患者于术后10 d 左右拔管,拔管后呼吸正常。2个月后3例出现呼吸困难,其中1例为声门区肉芽生长,取除肉芽组织后呼吸恢复正常;2例为前联合粘连,长期带管。所有患者均经口进食,发音质量良好。随访3～10年,死亡1例,失访1例。结论声门型喉癌行垂直或超垂直半喉切除术后以双蒂肌软骨膜瓣重建,可较好地保存喉功能,减少并发症,提高患者生活质量。(中国眼耳鼻喉科杂志,2007,7:236-237)

Purpose To study the application of bipedicle stemohyoid muscle and perichondrial （BSMP） flap in vertical partial laryngectomy for glottic carcinoma of the larynx. Methods Twenty-three patients with laryngeal carcinoma （T1 ： 8 cases, T2：15 cases） were treated with vertical or expanded vertical partial laryngectomy and repaired with BSMP flap to reconstruct laryngeal function. Results The respiratory function of all patients were normal when the tracheal tube was extracted about 10 days after surgery. However, 3 patients had dyspnea 2 months later. Among them, 1 patient had granulation in vocal area, whose respiratory function returned to normal after the granulation was removed ; and 2 patients had conglutination in anterior commissure of vocal cords, who had to reinstall tracheal tubes in long-term. The deglutitive and phonatory function returned to normal after surgery. Most of the patients except one were followed up for 3 to 10 years. One patient is dead. Conclusion Application of BSMP flap in vertical partial laryngectomy for glottic carcinoma of the larynx is feasible, in which laryngeal function can be reserved. This remedy can improve life quality, increase survival rate and lower the incidence of complications.