[A clinical study on improving phonation function of larynx after partial laryngectomy].

OBJECTIVE

To analyse the clinical results of reconstruction of vocal cord using sternohyoid muscle flap after partial laryngectomy and research a new repairing method to improve laryngeal function and living quality of patient.

METHOD

The pronunciation of larynx is on the basic of the vibration of the vocal cord by air current. The laryngeal appearance and the function of opposite side vocal cord is very important for improving the quality of pronunciation. We developed a technique of thyroid cartilage membrane and sternohyoid muscle flap to repair the defect left by a vertical laryngectomy and reconstructed the vocal cord. The thyroid cartilage membrane was used to bridge over the upper part defect of laryngeal cavity, the sternohyoid muscle flap forming the opposite side was made a 90 degree bent toward the laryngeal cavity to repaired the lower part defect of laryngeal cavity and reconstruct a new vocal cord. The repaired larynx recovered the normal appearance. The new vocal cord participated speech. The anterior 2/3 part of both vocal cored could contacted in pronunciation of patient. The phonation function of larynx was restored.

RESULT

Sixty-one cases partial laryngectomy was taken including vertical partial laryngectomy in 37 cases, extended vertical partial laryngectomy in 24. During their operations, the laryngeal defect was repaired with thyroid cartilage membrane and sternohyoid muscle flap, and a vocal cord was reconstructed in the same time. After operation, the laryngeal cavity repaired has a normal appearance, and the laryngeal satisfactory phonation effect has been obtained. 93.4% of the patients enjoyed a socially acceptable voice and rejoined normal working.

CONCLUSION

A technique of thyroid cartilage and sternohyoid muscle flap to repair the defect and reconstructive vocal cord after partial laryngectomy make patient recover normal laryngeal appearance and obtain satisfactory phonation effect. Among the method of repairation for partial laryngectomy sternohyoid muscle flap should be first considered owing to its various merits: 1. abundant material. 2. convenient procedures. 3. smaller trauma. 4. satisfactory effect.