全喉切除一期发音重建术

Total Laryngectomy for Vocal Rehabilitation by First Intention

目的 :总结对晚期喉癌患者施行全喉切除术后 ,一期完成发音重建术的方法、要点及效果。方法 :对11例晚期喉癌患者施全喉切除 ,同时切除双侧咽缩肌、进行气管 食管造瘘 ,一期完成发音重建术。结果 :11例患者术后均能正常进食 ,经安放硅胶发音钮后 ,均成功发音 ,随访三个月 ,其中9例言语自如 ,音量及音质均佳 ,2例话音连续性差、音量较低。结论 :在全喉切除术中切断咽缩肌同时进行食管 气管造瘘可提高发音重建术的成功率。

Objective:To study a novel surgical method for vocal rehabilitation by first intention in patients after total laryngectomy.Method:Eleven patients suffered from advanced laryngocarcinoma underwent total laryngectomy,and their vocal rehabilitation treatment were simultaneously performed by cutting off bilateral pharyngeal constrictors and creating a tracheo-esophageal shunt.Result:All eleven patients were able to eat and drink just after operation.By placing a silicone voice generator,they could enunciate successfully.At three-month follow-up,the nine out of eleven patients could speak clearly with satisfactory voice,two remaining patients could not speak continuously with lower voice.Conclusion:Our results shows that the total laryngectomy in combination of cutting off bilateral pharyngeal constrictors and creating a tracheo-esophageal shut,may improve successful vocal rehabilitation.