Nong H U, Mo W, Huang G W, Chen L, Guo Y C
Department of Otorhinolaryngology, Affiliated Hospital of Guahgxi Medical College, Nanning China.
Otolaryngol Head Neck Surg. 1991 Jun;104(6):809-13. doi: 10.1177/019459989110400607.
Epiglottic laryngoplasty is technically feasible as a one-stage procedure with excellent functional results. Although the Kambic-Sedlacek-Tucker (K-S-T) technique of glottic reconstruction offers early extubation with an adequate airway, a subsequent wide neoglottis may increase the chance of aspiration and a poor voice. To better restore the laryngeal functions of closure and phonation, we made some modifications on the original K-S-T technique as follows: (1) One of the lateral margins of the epiglottis with the aryepiglottic fold is sutured to the arytenoid region of the cricoid rather than a thyroid cartilage remnant. A neo-arytenoid is formed. (2) The other lateral margin of the epiglottis with the aryepiglottic fold is sutured to the cut edge of the false and true cord instead of a thyroid ala remnant. Therefore both margins of the epiglottis with the aryepiglottic folds are lowered as much as possible to the level of the glottis. A new pseudocord is formed. (3) A cartilage cut is made at the anterior aspect of the epiglottis, leaving its laryngeal surface of mucoperichondrial intact. A new anterior commissure with a sharp angle is shaped by this maneuver. Nineteen hemilaryngectomies with modified epiglottic laryngoplasty have been performed by members of the Department of Otolaryngology of Guangxi Medical College since 1984. Results in this series are fairly good and indicate that the modified epiglottic laryngoplasty is effective in enhancing functional results in terms of respiration, deglutition, and phonation.
会厌喉成形术作为一种一期手术在技术上是可行的，且功能效果极佳。尽管坎比克-塞德拉塞克-塔克（K-S-T）声门重建技术能实现早期拔管并提供足够的气道，但随后形成的宽大新声门可能会增加误吸的几率且嗓音质量差。为了更好地恢复喉部的关闭和发声功能，我们对原始的K-S-T技术做了如下改进：（1）将会厌的一侧边缘连同杓会厌襞缝合至环状软骨的杓状软骨区域，而非甲状腺软骨残端。形成一个新的杓状软骨。（2）将会厌的另一侧边缘连同杓会厌襞缝合至假声带和真声带的切缘，而非甲状腺翼板残端。因此，会厌的两侧边缘连同杓会厌襞尽可能降低至声门水平。形成一条新的假声带。（3）在会厌的前方做软骨切口，使其喉面的黏膜软骨膜保持完整。通过这一操作形成一个锐角的新前联合。自1984年以来，广西医科大学耳鼻咽喉科的成员已对19例患者实施了改良会厌喉成形术联合半喉切除术。该系列结果相当良好，表明改良会厌喉成形术在改善呼吸、吞咽和发声功能方面是有效的。
