摘要
1996年2月至1998年1月收治喉癌累及会厌根及声门下患者10例,按1987年 UICC 标准10例中 T_3N_(1b)1例,T_3N_28例,T_4N_21例,其中4例系喉癌行喉部分切除后复发,病变均为双侧声、室带会厌根受累,其中1例累及梨状窝内侧壁,3例累及声门下。6例行单侧颈廓清术,4例行双侧颈廓清及上纵隔廓清术。手术切除肿瘤后利用舌瓣下拉整复咽、喉及气管前、外侧壁缺损,6例恢复喉的3项功能,4例恢复吞咽及发音功能。随访满1年8例,1例局部复发并颈淋巴转移拒绝治疗死亡。生存满2年者3例,均健在。除3例发生皮下感染经换药治愈外,无其它并发症发生。本术式对使用常规整复方法难以恢复功能的病例有较满意的效果。
Laryngeal carcinoma involved the base of epiglottis and subglottie after surgical resection can obtain satisfactory effect by using tongue flap to reeonstruet laryngeal defect.10 patients who had undergone such operations from February 1996 to January 1998 were reported.There were T_3N_1 1 ease,T_3 N,8 eases,T_4N_2 lease according to UICC staging in 1987 including 4 cases recurrent affer partial laryngectomy.All lesions located in false vocal cords,vocal cords bilaterally and involved the base of epiglottis including 1 case invaded the medial wall of pyriform sinus and 3 eases invaded subglottic.6 patients underwent ipsilateral modified radical neck dissection and 4 patients underwent bilateral modified radical neck dissection and supradiaphragmatic dissection.6 patients restored all laryngeal function and 4 patients restored phonation and deglutition after operation.The follow-up period of 8 eases was over 1 year. Of the 8 cases,1 died.The fellow-up period of 3 cases was over 2 years.All were surveyed.No fatal complication occurred except subcutaneous infection in 3 patients.The operation has a significant effect on the case that is difficult in reconstruction laryngeal function for general method.
关键词
喉肿瘤
喉切除术
舌瓣
喉重建
Laryngeal neoplasms
Laryngectomy
Tongue flap
Laryngeal reconstruction
