Guinchard Anne-Claude, Monnier Philippe, Jaquet Yves, Monnier Yan, Ikonomidis Christos
Department of Otorhinolaryngology, Head and Neck Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland.
Department of Otorhinolaryngology, Head and Neck Surgery, HNE, Neuchâtel, Switzerland.
Head Neck. 2016 Nov;38(11):1722-1727. doi: 10.1002/hed.24476. Epub 2016 Apr 22.
Partial laryngectomy techniques are challenging, especially in young patients where function has to be preserved without compromising the oncologic outcome. We present a modified laryngectomy technique indicated for tumors invading one hemicricoid.
Vertical hemilaryngectomy with reconstruction of neo-glottis by hemi trachea and placement of an endolaryngeal silicon prosthesis for a 21-y old female patient presenting with a synovial sarcoma located on the left arytenoid area.
The prosthesis was removed at 6 w with tracheotomy closure at 8w post-op. Patient underwent adjuvant radiotherapy. Functional outcome showed good swallowing without aspiration. Voice was hoarse. At 5 years post-op the patient is free of recurrence presenting only mild dyspnea upon effort.
Vertical hemilaryngectomy including a hemicricoid is feasible with single stage reconstruction by a hemi-trachea of 4 to 5 rings intussuscepted into the thyroid cartilage. The functional outcome is good considering oncologic safety and avoidance of a permanent tracheostomy. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.
部分喉切除术技术具有挑战性，尤其是对于年轻患者，在不影响肿瘤治疗效果的情况下必须保留功能。我们介绍一种改良的喉切除术技术，适用于侵犯一侧半环状软骨的肿瘤。
对一名21岁女性患者实施垂直半喉切除术，通过半气管重建新声门，并放置喉内硅胶假体，该患者左杓状软骨区域患有滑膜肉瘤。
术后6周取出假体，8周关闭气管切开术。患者接受辅助放疗。功能结果显示吞咽良好，无呛咳。声音嘶哑。术后5年，患者无复发，仅在用力时出现轻度呼吸困难。
包括半环状软骨的垂直半喉切除术通过将4至5个环的半气管套入甲状腺软骨进行一期重建是可行的。考虑到肿瘤学安全性和避免永久性气管造口术，功能结果良好。©2016威利期刊公司。《头颈》38: 1708 - 1716, 2016。
