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改良额侧喉切除术治疗累及前联合的声门型T1(a - b)期癌。

Modified fronto-lateral laryngectomy in treatment of glottic T1(a-b) cancer with anterior commissure involvement.

作者信息

Dispenza Francesco, Saraniti Carmelo, Mathur Navneet, Dispenza Carlo

机构信息

Dipartimento Discipline Chirurgiche e Oncologiche UO Otorinolaringoiatria, Università degli Studi di Palermo, Palermo, Italy.

出版信息

Auris Nasus Larynx. 2010 Aug;37(4):469-73. doi: 10.1016/j.anl.2009.11.001. Epub 2009 Dec 23.

Abstract

OBJECTIVE

Evaluation of clinical and oncological safety of the modified fronto-lateral laryngectomy in the treatment of T1a-b glottic cancer.

METHODS

Retrospective review of charts of patients managed with classical fronto-lateral laryngectomy or with our modified technique using a cervical fascia flap and a false cord flap to reconstruct the defect.

RESULTS

No recurrence of cancer was observed in the present series and slight dysphonia was present in all cases. The patients managed with classical technique required a revision surgery for granulations or anterior synechia in 4 cases; those managed with modified technique did not need a second intervention.

CONCLUSION

The fronto-lateral laryngectomy should be present in the head-neck surgeon armamentarium. In T1a-b glottic cancer this technique gives a good oncological resection, but the postoperative period requires an intensive rehabilitation process. The modification of the classical technique reduces the incidence of a second intervention.

摘要

目的

评估改良额侧喉切除术治疗T1a - b期声门癌的临床及肿瘤学安全性。

方法

回顾性分析采用经典额侧喉切除术或我们使用颈筋膜瓣和假声带瓣修复缺损的改良技术治疗的患者病历。

结果

本系列未观察到癌症复发,所有病例均有轻度发音障碍。采用经典技术治疗的患者中有4例因肉芽组织或前粘连需要进行翻修手术;采用改良技术治疗的患者无需二次干预。

结论

额侧喉切除术应纳入头颈外科医生的手术技能范围。对于T1a - b期声门癌,该技术能实现良好的肿瘤切除,但术后需要强化康复过程。经典技术的改良降低了二次干预的发生率。

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