Department of Otorhinolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University, Shanghai, China.
Acta Otolaryngol. 2021 Apr;141(4):408-413. doi: 10.1080/00016489.2021.1877347. Epub 2021 Feb 13.
It is important for the patients to reconstruct the voice phonic function by surgery after total laryngectomy in the developing countries.
AIMS/OBJECTIVES: To investigate the clinical outcomes of voice reconstruction using an infrahyoid musculocutaneous flap for patients after total laryngectomies.
Eighteen male patients recruited were laryngectomized. The infrahyoid musculocutaneous flap was designed. After total laryngectomy, the lower edge of the flap was sewed with the upper edge of the tracheostomy opening. Next, the lateral and medial edges of the flap were anastomosed to create a pronunciation tube. Finally, the remaining opening of the tube was sutured with the anterolateral wall of the hypopharynx to establish a communication with the pharyngeal cavity.
A total of 17 cases of flaps were survived and only 1 necrosed. There were 17 patients without serious complications, except that 6 cases had mild irritable cough when gulping water. However, it could be relieved through blocking tracheostoma. One year after operation, all patients could more remarkably articulate clear, powerful, and consistent words. The articulatory configuration was existed under rigid laryngoscope and CT.
The use of an infrahyoid myocutaneous flap is feasible for the voice restoration in the patients undergoing total laryngectomy.
在发展中国家，全喉切除术后患者通过手术重建语音功能非常重要。
探讨应用胸舌骨肌皮瓣重建全喉切除术后患者嗓音的临床效果。
纳入 18 例男性患者行全喉切除术，设计胸舌骨肌皮瓣。全喉切除术后，将皮瓣的下缘与气管造口的上缘缝合。然后，将皮瓣的外侧和内侧边缘吻合，形成发音管。最后，将管的剩余开口与下咽前外侧壁缝合，与咽腔相通。
共 17 例皮瓣存活，仅 1 例发生坏死。除 6 例患者吞咽水时出现轻度刺激性咳嗽外，其余 17 例患者均无严重并发症，但通过堵塞气管造口可缓解。术后 1 年，所有患者均可更清晰、有力、一致地发音。在硬性喉镜和 CT 下可观察到发音结构。
应用胸舌骨肌皮瓣进行全喉切除术后的嗓音重建是可行的。
