Zhao Xiaolong, Ma Zhiyue, Li Bilan, Feng Yong, Yu Xiaoxu, Fan Jiangang, He Gang, Li Bin
Department of Otolaryngology Head and Neck Surgery，Sichuan Provincial People's Hospital，School of Medicine，University of Electronic Science and Technology，Chengdu，610000，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Oct;36(10):753-757. doi: 10.13201/j.issn.2096-7993.2022.10.005.
To investigate the clinical effect of one-stage sternohyoid musculocutaneous flap after total laryngectomy for reconstruction of epiglottis function and vocalization. A retrospective analysis of 8 patients who underwent total laryngectomy from November 2019 to September 2020. The sternohyoid myocutaneous flap was designed after total laryngectomy. The lower edge of the flap was sewed with the posterior upper edge of the tracheostomy opening, and the lateral and medial edges of the flap were anastomosed to create a vocal tube. The lateral edge of the upper end of tube was sutured with the anterolateral wall of the hypopharynx, then made full use of residual epiglottis and tongue root tissue to reconstruct epiglottis function. None of the 8 patients had serious complications after total laryngectomies. Fifteen months after operation,the vocal tube flaps survived and had intact structure under fiberoptic laryngoscope. All patients could speak clearly and forcefully, and the swallowing function was intact. The use of adjacent myocutaneous flap to construct the vocal canal and reconstruct the epiglottis function is a simple and effective technique that can be completed in one stage and improve the voicing of patients undergoing total laryngectomy.
探讨全喉切除术后一期应用胸骨舌骨肌皮瓣重建会厌功能及发声的临床效果。回顾性分析2019年11月至2020年9月行全喉切除术的8例患者。全喉切除术后设计胸骨舌骨肌皮瓣。将皮瓣下缘与气管造口后上缘缝合，皮瓣内外侧缘吻合形成声管。声管上端外侧缘与下咽前外侧壁缝合，然后充分利用残余会厌及舌根组织重建会厌功能。8例患者全喉切除术后均未出现严重并发症。术后15个月，声管皮瓣存活，纤维喉镜下结构完整。所有患者均能清晰有力地发声，吞咽功能完好。应用邻近肌皮瓣构建声道并重建会厌功能是一种简单有效的技术，可一期完成，改善全喉切除患者的发声。
