喉部分切除术应用自体耳廓软骨喉成形术

Laryngoplasty with autoconchal cartilage in partial laryngectomy

目的探讨喉部分切除术应用自体耳廓软骨喉成形术的可行性及喉部分切除术修复材料的选择。方法我科1992～1999年采用该术式治疗喉癌38例,男36例,女2例,平均年龄59岁。T_2N_0M_021例,T_3N_0M_017例;声门型36例,贯声门型2例。应用自身耳廓软骨修补残喉。结果 3、5年成活率分别为81.2%(31/38)、71.1%(27/38)。喉功能恢复情况拔管率94.7%,吞咽功能在术后7～10 d内恢复,无呛咳,发音功能良好,全部耳廓软骨均成活。结论该术式能彻底切除肿瘤,并保留喉的生理功能。自体耳廓软骨是一种较理想的喉部分切除术的修复材料。

Purpose To explore the feasibility of application of autoconchal cartilage in laryngoplasty and the choice of reparative materials for partial laryngectomy. Methods Thirty-eight patients with laryngeal cancer from 1992 to 1999 were reviewed, including 36 males and 2 females. The average age was 59 years old. There were 21 cases in T2N0M0, 17 cases in T3N0M0,36 patients with glottic cancer and 2 patients with transglottic cancer. All of them were chosen to use autoconchal cartilage to repair remnant larynges. Results Three-year survival rate is 81.2% (31/38) , and five-year survival rate is 71.1%(27/38). The decannulation rate is 94.7% and swallow function recovered in postoperative 7th to 10th day. Aspiration wasn't found and voice function was perfect. All of the conchal cartilage remained alive. Conclusion This operative style can clear neoplasm completely and retain laryngeal physiological function. Autoconchal cartilage is a good choice of reparative materials for partial laryngectomy.