Zhang Liqiang, Luan Xinyong, Pan Xinliang, Xie Guang, Xu Fenglei, Liu Dayu, Lei Dapeng, Yang Qiuan
Department of Otorhinolaryngology, Qilu Hospital, Shandong University, Jinan 250012, China.
Zhonghua Zhong Liu Za Zhi. 2002 May;24(3):288-90.
To study the feasibility, surgical technique and results of laryngeal function preservation in surgical treatment for medial wall pyriform sinus cancer.
From 1992 to 1999, 31 patients with medial wall pyriform sinus cancer including stage I 1, II 4, III 14 and IV 12 lesions were treated. Partial resection of pyriform sinus and partial laryngectomy were performed, then, the remains of epiglottis and uni-pedicled sternohyoid myofascial flap were used to restore the defects of larynx. At last, the remaining hypopharyngeal mucosa was sutured to cover the wound of hypopharynx and for artificial rebuild-up. All patients received postoperative radiotherapy.
The 3- and 5-year survival rates were 62.1% and 43.6% respectively, with 77.4% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 32.6% partially restored (voice and deglutition).
Conservative surgery so introduced is feasible for selected medial wall pyriform sinus cancer patients with the lesion completely resected.
探讨梨状窝内侧壁癌手术治疗中保留喉功能的可行性、手术技巧及效果。
1992年至1999年，对31例梨状窝内侧壁癌患者进行治疗，其中Ⅰ期1例、Ⅱ期4例、Ⅲ期14例、Ⅳ期12例。行梨状窝部分切除及部分喉切除术，然后利用会厌残端及单蒂胸骨舌骨肌肌筋膜瓣修复喉缺损。最后，将剩余下咽黏膜缝合覆盖下咽创面并进行人工重建。所有患者术后均接受放疗。
3年和5年生存率分别为62.1%和43.6%，77.4%的患者喉功能（发声、呼吸和吞咽）完全恢复，32.6%的患者部分恢复（发声和吞咽）。
对于病变能够完全切除的部分选择性梨状窝内侧壁癌患者，所采用的保守手术是可行的。
