甲状软骨双蒂肌软骨膜瓣在部分喉切除术中的应用

The application of thyroid cartilage and bi pedical muscle and perichonrium flap in vertical partial laryngectomy

目的：修复垂直部分喉切除后的缺损，重建良好的喉功能。方法：在垂直部分喉切除后，将带有甲状软骨外膜的胸骨舌骨双蒂肌移至喉腔缺损处，以修复创面，并在软骨膜与双蒂肌之间作一隧道，嵌入一适当大小的条状甲状软骨片，固定与对侧声带同一平面位置，形成一新声带。结果：术后随访１年以上，患者均恢复了良好的吞咽及发音功能，拔管率为１００％。结论：设计的肌瓣能有效修补喉缺损，防止喉狭窄，重建良好发音功能。

Objective: For reconstruction of the function of the larynx, we designed a technigue of thyroid cartilage and bi pedical muscle and perichondrium flap(TC BPM PF)to repair the defect after vertical partial or expanded vertical partial laryngectomy. Methods: The TC BPM PF was obtained from sternothyroid muscle, thyroid muscle, and exterior perichondrium of thyroid cartilage, and a long narrow piece of thyroid cartilage(wideth about 4 mm,length as opposite vocal cord) was placed between the muscle and perichondrium. The piece of thyroid cartilage was fixed on a level with opposite vocal cord and took shape of a new vocal cord. Results: The patients were followed up for more than 1 year after operation and it was found that all the patients had resumed a socially acceptable voice and normal mouth food taking. The tracheal tube extraction rate was 100%. Conclusion: The TC BPM PF can effectively repair the defect after vertial partial laryngectomy, and avoid stricture of the larynx, and reconstruct the function of voice.