激光治疗喉癌前病变

Laser assisted phonomicrosurgery for premalignant lesions of the larynx

目的在手术治疗喉癌前病变的同时,最大限度的保留和恢复喉的正常发音功能。方法应用激光外科手术治疗喉癌前病变77例,其中采用声带黏膜上皮层切除术治疗声带黏膜白斑及轻度不典型增生23例;采用声带黏膜剥脱术治疗中、重度不典型增生44例;激光切除成人型喉乳头状瘤10例。结果23例声带黏膜白斑及轻度不典型增生者术后2个月发音恢复正常;44例中、重度不典型增生者术后3～5个月发音逐渐恢复正常;10例喉乳头状瘤患者术后发音明显优于经颈进路手术的发音。结论嗓音显微外科手术既能分层切除声带病变,又能最大限度的保留和恢复喉的发声功能,是治疗喉癌前病变首选的微创性方法。

OBJECTIVE To find a way of reserving high quality phonation function after phonomicrosurgery for premalignant lesions of the larynx. METHODS There were 77 cases with leukoplakia or atypical hyperplasia of the vocal cord included in this study. They were all treated with phonomicrosurgical techniques as mucosal epithelium ablation or mucosal stripping by using CO2 laser. Ten patients with laryngeal papilloma were excised by CO2 laser. RESULTS Twenty three patients with leukoplakia or mild atypical hyperplasia of the vocal cord achieved a normal phonation within 2 months. The 44 patients with moderate and advanced hyperplasia need 3-5 months to recover the normal phonation. Phonation recovery of the 10 patients with laryngeal papilloma treated with CO2 laser was better than patients treated with transcervical approach. CONCLUSION The CO2 laser assisted phonomicrosurgery is a reliable method for management the premalignant lesions of the larynx, which not only can remove the lesions and also can restore good voice function.