磷酸钛钾激光声带切除术不同术式的临床特点

Clinical characteristics of different cordectomy types with potasium titanium phosphate laser

目的 探讨支撑喉镜下磷酸钛钾 (potasiumtitaniumphosphate,KTP)激光声带切除术不同术式的选择及愈合过程中的临床特点。方法 选择 76例早期声门型喉癌行KTP激光声带切除术 ,对不同术式术后喉内结构恢复过程、音质变化等进行随访观察记录。结果 Ⅰ型术式 11例 ,3个月后恢复喉的正常结构及功能 ;Ⅱ型术式 5 0例 ,3个月后有声带样粘膜皱襞 (以下称新声带 )形成 ,基本恢复喉的结构 ;Ⅲ型术式 15例 ,6个月后多数形成粘膜隆起 ,但失去运动功能。复发时间集中在术后 2～ 4个月 ,复发率为 6 .7% ,2年及 5年生存率为 10 0 %。结论 KTP激光声带切除术疗效好 ,损伤小。Ⅱ型和Ⅲ型术式在保证根治癌肿的基础上应尽可能保留声带肌。

Objective To study the clinical characteristics of different potasium titanium phosphate(KTP) laser types and surgical the recuperating course of cordectomy under suspension laryngoscope. Method Follow up observation were applied on 76 patients with cordectomy. Restoration of laryngeal structure and change of the quality of voice were observed and recorded. Results Type 1, normal laryngeal structure and function were restored postoperatively after 3 months; Type 2, a fold like vocal cord (new vocal cord) appeared 3 months later. Laryngeal structure was basically restored; Type 3, a mucosal fold appeared postoperatively after 6 months in most patients, but it lost motion function. Recurrence time was mainly found 2 4months.Recurrence rate was 6.7%. Two and 5 year survival rate were 100%. Conclusions Cordectomy with KTP laser can result in good effect and less injury. Type 2,3 can retain thyroarytenoid muscle as much as possible on the basis of radical cure.