声门癌部分喉切除后不同重建方法发音效果观察

Study of phonation after partial laryngectomy for glottic carcinoma of the larynx

目的观察18例声门癌(T_(1～3)NoMo)患者行部喉切除术后喉形态及发音情况。方法在喉癌完整切除后选用几种不同修补方法:1.皮瓣法;2.双蒂肌软骨膜瓣法;3.单蒂肌新声带成形法;4.甲状软骨双蒂肌软骨膜瓣法。结果后两种方法能较好地重建喉的形态及恢复良好的发音功能,甲状软骨双蒂肌软骨膜瓣法新成形的声带是一垂直平面,其僵硬度不妨碍健侧声带振动,能产生接近正常的声音。结论后两种方法值得推广。

PURPOSE To observe laryngeal shape and function of phonation of 18 patients with glottic carcinoma after vertical partial laryng-ectomy.METHODS We used four reconstruction methods for the laryngeal defects: 1. cervical skin flap, 2. bi-pedicle muscle and perichondrium flap, 3. uni-pedicle muscle flap, 4. small piece of thyroid cartilage and bi-pedicle muscle and perichondrium flap(TC-BPM-PF).RESULTS The last two methods can reconstruct better laryngeal shape and function of phonation,TC-BPM-PF takes the shape of a new vocal cord that appears to be a vertical plane,which is advantageous to vibration of opposite vocal cord.CONCLUSIONS The last two methods are worthy to be popularized.