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一种用于前外侧部分喉切除术后功能重建的改良假声带瓣:与传统开放性切除术和激光声带切除术的比较。

A modified false vocal fold flap for functional reconstruction after frontolateral partial laryngectomy: a comparison with conventional open resection and laser cordectomy.

作者信息

Lorenz Kai J, Kohnle Roland, Maier Heinz

机构信息

Department of Otolaryngology/Head and Neck Surgery, German Armed Forces Hospital of Ulm, Ulm, Germany.

出版信息

GMS Interdiscip Plast Reconstr Surg DGPW. 2013 Oct 23;2:Doc14. doi: 10.3205/iprs000034. eCollection 2013.

Abstract

OBJECTIVE

To describe a modified flap technique (MFT) involving the use of a false vocal fold flap for glottic reconstruction and the removal of arytenoid cartilage and to compare it with conventional frontolateral partial laryngectomy (FLPL) and laser cordectomy (LC).

METHODS

Twenty-eight MFT, 13 FLPL and 12 LC patients completed a standardised questionnaire for assessing aspiration, respiration, quality of life, and subjective voice quality. We analysed vocal function in terms of roughness, breathiness and hoarseness, measured voice range profiles, and performed videoendoscopy.

RESULTS

No patient reported respiratory problems. Aspiration occurred in 33.3% (MFT), 41.6% (FLPL) and 16.6% (LC). Voice quality was rated as good/satisfactory by 17 MFT patients (62%), satisfactory/sufficient by 69% of FLKT patients, and sufficient/poor by 75% of LC patients.

CONCLUSIONS

The modified false vocal fold flap effectively covers defects and creates a neocord that ensures good phonatory rehabilitation and has positive effects on postoperative quality of life.

摘要

目的

描述一种改良皮瓣技术(MFT),该技术涉及使用假声带皮瓣进行声门重建及切除杓状软骨,并将其与传统的前外侧部分喉切除术(FLPL)和激光声带切除术(LC)进行比较。

方法

28例接受MFT、13例接受FLPL和12例接受LC的患者完成了一份标准化问卷,以评估误吸、呼吸、生活质量和主观嗓音质量。我们从粗糙、气息声和嘶哑方面分析了嗓音功能,测量了嗓音音域图,并进行了视频内镜检查。

结果

无患者报告呼吸问题。误吸发生率在MFT组为33.3%,FLPL组为41.6%,LC组为16.6%。17例MFT患者(62%)将嗓音质量评为良好/满意,69%的FLKT患者评为满意/足够,75%的LC患者评为足够/差。

结论

改良假声带皮瓣能有效覆盖缺损并形成新声带,确保良好的发声康复,对术后生活质量有积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f10f/4582486/122cc852c091/IPRS-02-14-t-001.jpg

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