Ma Shi-yin, Zhan Xiao-dong, Xu Shu-xiu, Zu Zhi-jiang, Yang Jia-shu, Shu Ji-hong, Wang Wen-zhong, Jiang Cheng-yi
Department of Otorhinolaryngology, Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2003 Dec;38(6):430-3.
To evaluate the methods of reconstruction of laryngeal function after the extended laryngectomy.
The laryngeal functions were reconstructed after the extended laryngectomy performed on 22 cases with the laryngocarcinoma of T2 and T3 stages of glottic type, using epiglottis and cervical anterior muscle to reconstruct the laryngeal cavity and larynx bracket, from September 1998 to October 1999.
Twenty cases recovered normal swallow function in 20 days post-operation as well as the entire function of larynx was recovered, and the rate of decannulation was 90.9% (20/22). One case with pharyngeal fistula recovered a month later, but the other case recovered to normal diet by operation repaired. All the patients pronounced clearly and were able to keep the characteristics of their own voice. The fibred laryngoscope examination showed that the sphincter valves were formed at the larynx atrium in all postoperative cases. The rate of 3-year survival for T2 and T3 stages was 100% (9/9) and 92.3% (12/13), respectively.
The laryngeal cavity could be enlarged and the laryngeal atrium was reconstructed by employing epiglottis ifraplacement and cervical anterior muscle to reduce the tension of epiglottis and minimize the injury of the membrane as well as to overcome the shortcomings of insufficient material if mere employing epiglottis. The application of combined methods to reconstruct the laryngeal cavity is a practical way to restore the larynx function and improve the life quality.
评估扩大喉切除术后喉功能重建的方法。
1998年9月至1999年10月，对22例声门型T2和T3期喉癌患者行扩大喉切除术后，采用会厌及颈前肌重建喉腔及喉支架以重建喉功能。
20例患者术后20天恢复正常吞咽功能，喉功能完全恢复，拔管率为90.9%（20/22）。1例咽瘘患者1个月后恢复，另1例经手术修复后恢复正常饮食。所有患者发音清晰，能保持自身嗓音特点。纤维喉镜检查显示，所有术后病例喉前庭均形成括约肌瓣。T2和T3期患者3年生存率分别为100%（9/9）和92.3%（12/13）。
采用会厌移位及颈前肌重建喉腔可扩大喉腔、重建喉前庭，降低会厌张力，减少黏膜损伤，克服单纯使用会厌材料不足的缺点。联合应用多种方法重建喉腔是恢复喉功能、提高生活质量的切实可行方法。
