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垂直部分喉切除术后胸锁乳突肌肌筋膜瓣喉重建术

Laryngeal reconstruction by platysma myofascial flap after vertical partial laryngectomy.

作者信息

Dursun Gursel, Ozgursoy Ozan Bagis

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Ankara University Faculty of Medicine, Bascavus Sokak, Maliye Bloklari, 91/10, 06660 Kucukesat, Ankara, Turkey.

出版信息

Head Neck. 2005 Sep;27(9):762-70. doi: 10.1002/hed.20241.

Abstract

BACKGROUND

Many methods of glottic reconstruction have been described for patients undergoing vertical partial laryngectomy to reestablish the glottic integrity.

METHODS

Fifteen patients with T2 squamous cell carcinoma of the glottis were included in this prospective clinical trial. All patients were treated by vertical partial laryngectomy with laryngeal reconstruction by platysma myofascial flap. The surgical procedure and flap design were described. Vocal function was assessed by videolaryngostroboscopy and subjective and objective voice analysis before and after surgery.

RESULTS

Complete neoglottic closure and acceptable voice quality were obtained by platysma myofascial flap in all cases. No statistically significant difference was found between the preoperative and postoperative acoustic parameters.

CONCLUSIONS

Platysma myofascial flap provides the basic requirements for laryngeal reconstruction with its own favorable characteristics and also allows complete glottic closure without interfering with respiration and deglutition. This technique may be an effective alternative achieving an acceptable quality of voice.

摘要

背景

对于接受垂直部分喉切除术的患者,已经描述了许多重建声门完整性的方法。

方法

15例声门T2期鳞状细胞癌患者纳入本前瞻性临床试验。所有患者均接受垂直部分喉切除术,并采用颈阔肌肌筋膜瓣进行喉重建。描述了手术过程和皮瓣设计。术前和术后通过电子喉镜频闪喉镜检查以及主观和客观语音分析评估嗓音功能。

结果

所有病例中,颈阔肌肌筋膜瓣均实现了新声门的完全闭合,且嗓音质量可接受。术前和术后声学参数之间未发现统计学上的显著差异。

结论

颈阔肌肌筋膜瓣凭借自身有利特性满足了喉重建的基本要求,还能实现声门完全闭合,且不干扰呼吸和吞咽。该技术可能是实现可接受嗓音质量的有效替代方法。

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