声门型喉癌垂直喉部分切除术后修复方法探讨

Study of the reconstruction methods after vertical partial laryngectomy for glottic carcinoma of the larynx

目的 :研究声门型喉癌垂直部分喉切除术后修复方法。方法 :回顾性分析 5 8例声门癌行垂直或扩大垂直部分喉切除术的临床资料 ,总结各种修复术后喉功能恢复情况。结果 :术后 3、5年生存率分别为 87.2 %和80 .5 % ,总拔管率 93.1% ,全部患者均获得不同程度的发音功能 ;误吸 3例 ,全部恢复经口进食。结论 :声门型喉癌术后修复方法主要根据患者病变切除范围而定 ,对于病变切除小者选用带状肌瓣修复最理想 ,对于切除范围大者 ,则用鼻中隔软骨作支架 ;若为次全喉切除 ,则选用 Tucker术式。

Objective:To study the reconstruction methods after vertical partial laryngectomy for glottic carcinoma of the larynx. Method:58 cases with glottic carcinoma of the larynx were treated with vertical partial laryngectomy or extended vertical partial laryngetomy .The clinical materials of these cases were retrospectively studied.Result:The total decannulation rate was 93.1 % and the 3 and 5 year survival rates were 87.2 % and 80.5 % respectively .The voice was socially acceptable in 93.1 %(54/58) of the patients. Aspiration was only 3. All resumed mouth food taking.Conclusion:The reconstruction methods after vertical partial laryngectomy were mainly decided by the extent of the laryngeal defect. If the laryngeal defect of the framework was small, the pedicle muscular flap was the best reconstruction method in comparison with other reconstruction methods .If the laryngeal defect of the framework was too big ,allograft nasal septal cartilage or epiglottic laryngoplasty should be performed .