气管造口成形术：一种改善管内造口纽扣留置以实现免持式气管食管语音的手术方法。
Tracheostomaplasty: A surgical method for improving retention of an intraluminal stoma button for hands-free tracheoesophageal speech.
机构信息
Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
出版信息
Head Neck. 2010 Dec;32(12):1674-80. doi: 10.1002/hed.21379.
BACKGROUND
We describe a minimally invasive surgical technique, tracheostomaplasty, to overcome anatomical deformities of the stoma that preclude successful retention of a stoma button for hands free tracheoesophageal (TE) speech.
METHODS
We conducted a retrospective analysis of 21 patients who underwent tracheostomaplasty after laryngectomy to accommodate an intraluminal valve attachment for hands-free TE speech.
RESULTS
Sixteen men and 5 women (median age, 65 years; median follow-up, 27.7 months) underwent tracheostomaplasty; 6 patients developed a mild cellulitis that required therapy and 5 patients required a minor revision surgery. At last follow-up, 15 (71%) patients successfully achieved hands-free TE speech using an intraluminal stoma button. Three patients only retained the intraluminal device to facilitate digital occlusion. Tracheostomaplasty failed in 3 patients because of granulation tissue formation or stomal stenosis.
CONCLUSIONS
Tracheostomaplasty is a successful technique to improve intraluminal retention of a stoma button for hands-free TE speech in laryngectomy patients.
背景
我们描述了一种微创外科技术，即气管造口成形术，以克服会妨碍气切扣环自由固定于气管食管（TE）造口以实现免持式 TE 语音的解剖畸形。
方法
我们对 21 例因内置阀附件需要而接受气管造口成形术以适应免持式 TE 语音的喉切除术后患者进行了回顾性分析。
结果
16 名男性和 5 名女性（中位年龄 65 岁；中位随访时间 27.7 个月）接受了气管造口成形术；6 例患者发生轻度蜂窝织炎，需要治疗，5 例患者需要进行小的修正手术。最后一次随访时，15 例（71%）患者成功地使用内置式气切扣环实现了免持式 TE 语音。3 例患者仅保留内置设备以方便手指闭塞。3 例患者因肉芽组织形成或造口狭窄而导致气管造口成形术失败。
结论
气管造口成形术是一种成功的技术，可改善喉切除术后患者的气管造口内置式扣环固定，从而实现免持式 TE 语音。
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