扩大声门上水平喉部分切除术在中晚期喉癌及会厌谷癌中的应用

The application of extended supraglottic horizontal partial laryngectomy in advanced laryngeal carcinoma and vallecula carcinoma

目的:探讨扩大声门上水平喉部分切除术对中晚期喉癌及会厌谷癌的治疗效果及术后功能恢复的作用。方法:对44例喉癌患者均行扩大声门上水平喉部分切除术,即在原有声门上水平喉部分切除术基础上扩大切除范围,并对其术后生存及喉的呼吸、发声及吞咽功能恢复情况进行随访。结果:本组患者2年和3年生存率分别为72.7%和71.4%。术后随访无局部复发病例,死亡患者均由于颈部淋巴结转移或廓清后颈淋巴结复发。本组病例拔管率为97.7%(43/44)。术后42例(95.5%)发声良好,其余2例行杓状软骨部分切除患者发声中等。患者术后存在不同程度误咽,但经过练习后最终都拔除鼻饲。结论:扩大声门上水平喉部分切除术能够彻底切除肿瘤,术后喉部呼吸、吞咽和发声功能恢复满意。

Objective：To discuss the function recovery and treatment effect of extended supraglottic orizontalpartial laryngectomy in the treatment of advanced laryngeal carcinoma and vallecula carcinoma.Method：Forty-four patients who received extended supraglottic orizontalpartial laryngectomy were followed up on the survival,breath function,pronunciation and swallowing function.Result：The 2-year,3-year survival rates of this group were72.7% and 71.4%,respectively.There were no recurrence cases in this group.All cases of death were due to cervical lymph node metastasis or recurrent cervical lymph node metastasis after cervical lymph node dissection.The extractive rate of tracheostomy tube was 97.7%.Forty-two patients own good pronunciations.Two patients who received partial arytenoid cartilage resection own weaker pronunciations.After practising,all the patients can eat without the nasal feeding tube.Conclusion：Extended supraglottic orizontalpartial laryngectomy give complete resection of the primary lesion.Patients who received extended supraglottic orizontalpartial laryngectomy have good breath,swallowing and pronunciation function.