双蒂双肌瓣在喉狭窄治疗中的应用

The use of bi-pedical and bi-muscle flap in the treatment of laryngostenosis

目的 探讨喉肿瘤术后、喉外伤后导致的喉狭窄的手术治疗方法。方法 应用自行设计的双蒂双肌瓣 ,对 4 2例喉狭窄病例进行喉成形手术。结果 36例解除了喉狭窄 ,拔除了气管套管 ,拔管率为 85 7% ;胃管术后 7～ 10d均拔除。结论 双蒂双肌瓣植入伤口创面 ,可避免瘢痕增生 ,使手术成功率大大提高 ;且利用自体组织 ,就近取材 ,简单易行 ,值得推广应用。喉恶性肿瘤术后 1 5年 ,进行喉狭窄成形术较为适宜。喉支架切除过多 。

Objective To study the therapeutical method of laryngostenosis after operation for laryngeal tumor or laryngeal trauma.Methods Forty two cases of laryngostenosis were treated by laryngoplast using the bi pedical and bi muscle flap designed by us since 1986.Results Thirty six cases of laryngostenosis were cured,their tracheal tubes were removed,with a removal rate 85 7%.Stomach tubes were removed within 7 to 10 postoperative days.Conclusion The implantation of bi pedical and bi muscle flap into wound surface can avoid cicatricial hyperplasia,and greatly improve the success rate of operation.Autografting with nearby tissues made the operation simple and easy,worthy of being popularized.It is suitable to do laryngoplasty for laryngostenosis in 1 5 years after the operation for malignant laryngeal tumor.The method is not suitable for those treated by excessive resection of the laryngeal support.