全喉切除发音重建术中有关咽缩肌切断的认识——(附25例报告)

Consideration on Effectiveness of Amputating Cricopharyngeal Muscle and Unilateral Pharyngeal Constrictor on Voice Restoration After Total Laryngectomy

目的:探讨全喉切除发音重建中切断环咽肌与一侧咽缩肌对发音的影响。方法:分析25例全喉切除发音重建患者病例,同时选择了一组文献资料对照。结果:本组17例行环咽肌与一侧咽缩肌切断,有3例不能发音;未行环咽肌与一侧咽缩肌切断8例,2例不能发音。文献资料与本组资料均显示,是否切断环咽肌及一侧咽缩肌其发音重度差异无显著性。P≥0.05。结论:发音重建后,能否发音的是一个复杂的问题,环咽肌与咽缩肌痉挛仅仅是其中一个原因,要提高发音的成功率,还需从其它方面深入研究。

Objective: To study the influence of amputating cricopharyngeal muscle and unilateral pharyngeal constrictor after total laryngectomy on vocal restoration. Methods: Out of 25 patients being operated on, 17 cases underwent laryngectomy with amputating cricopharyngeus and unilateral pharyngeal constrictor, while the remaining 8 cases without such amputation, vocal function between two groups was compared on speech restoration after positioning special appliance. Results: Of 17 patients, 14 cases speech was partially restored, while other 3 cases were unable to speech. Of 8 controls, 6 cases' speech was partially restored, while the remaining 2 were unable to speech, the difference between them was not statistically significant P > 0.05. Conclusion: The mechanism involved in vocal restoration after total laryngectomy and positioning special appliance seems to be complicated, the spasm of cricopharyngeal muscle and pharyngeal constrictor appears to be one reason only, more detailed studies is needed to improve the successful rate of pronunciation.