Ceylan Alper, Köybaşioğlu Ahmet, Asal Korhan, Kizil Yusuf, Inal Erdoğan
Department of Otolaryngology, Medicine Faculty of Gazi University, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2003 Dec;11(6):170-4.
We compared the effects of pharyngeal neurectomy (PN) and cricopharyngeal myotomy (CPM) on postoperative deglutition in patients undergoing horizontal supraglottic laryngectomy (HSL).
The study included 20 male patients (mean age 53 years; range 39 to 67 years) who underwent HSL for squamous cell carcinoma of the larynx. Tumor stages were T1 in two, T2 in 16 , and T3 in two patients. None had received radiotherapy before surgery. In order to decrease cricopharyngeal muscle spasm following HSL, the patients were randomly chosen for CPM (n=11) and PN (n=9). The two groups were compared with respect to the time to postoperative oral food intake.
No significant difference was found with respect to the time to postoperative oral feeding (mean 27 days, range 16 to 45 days in the CPM group; mean 25 days, range 16 to 36 days in the PN group; p>0.05). No significant relationship existed between primary tumor stages and the time to oral feeding (p>0.05). No complications were encountered in the two patient groups.
In supraglottic partial laryngectomies, PN seems to be as effective as CPM to decrease postoperative cricopharyngeal muscle spasm, with additional advantages of ease and safety.
我们比较了咽神经切除术（PN）和环咽肌切开术（CPM）对接受水平声门上喉切除术（HSL）患者术后吞咽功能的影响。
本研究纳入20例男性患者（平均年龄53岁；范围39至67岁），他们因喉鳞状细胞癌接受了HSL。肿瘤分期为T1期2例，T2期16例，T3期2例。所有患者术前均未接受过放疗。为了减少HSL术后环咽肌痉挛，患者被随机分为CPM组（n = 11）和PN组（n = 9）。比较两组术后经口进食的时间。
术后经口进食时间方面未发现显著差异（CPM组平均27天，范围16至45天；PN组平均25天，范围16至36天；p>0.05）。原发肿瘤分期与经口进食时间之间无显著相关性（p>0.05）。两组患者均未出现并发症。
在声门上部分喉切除术中，PN在减少术后环咽肌痉挛方面似乎与CPM一样有效，且具有操作简便和安全的额外优势。
