摘要
目的 探讨喉全切除术后失声病人重新恢复喉功能的手术法。方法 对36例病人行喉二期发音功能重建术。喉全切除术后时间为2～43个月,平均15个月,采用颈部肌皮瓣连结咽和气管,同时用皮瓣制做会厌,达到能发音、呼吸、吞咽保护功能的目的。结果 全部患者能发音,用手指堵管可以口头交谈,1例已拔除气管套管,3例可完全堵管,并发症为误吸较重3例,其中1例并发严重肺内感染后死亡,2例再次封闭喉口失音。术后气管造口复发癌2例。结论 喉全切除术后二期发音重建术能恢复喉发音功能。
Objective To study operation method restoring laryngeal function of patients after total laryngectomy. Methods A retrospective review was made about 36 patients treated by total laryngectomy and secondary stae operation laryngeal reconstruction. The duration after total laryngectomy was 2-43 monthes, with mean 15 month. The method of this operaion is that the cervical muscle flap was used to link pharynx and trachea, at the same time making as epiglottis, reaching phonation and breath, swallowing function of protection. Results All patients can phonate clearly and use finger of obstruction. One case can breath through the larynx after decannulation, three cases can stop up cannula and breate freely. Three cases got serious complication because of inspiration in error way, one of them died due to serious pulmonary infection. Two of them fall to phonate again due to blocking. Two case was postoperative tracheostoma recurrence cancer.Conclusion Secondary stage operation in laryngeal phonation reconstruction after total laryngectomy obtain favorable result in restoring laryngeal function.
