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环状软骨甲状膜缝合水平部分喉切除术治疗 T1b 期声门型喉癌

Horizontal middle partial laryngectomy with cricothyroidopexy: an effective treatment for stage T1b glottic carcinoma.

机构信息

Department of Otolaryngology Head and Neck, Fuzong Clinical College, Fujian Medical University, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China.

出版信息

Acta Otolaryngol. 2023 Sep;143(9):823-828. doi: 10.1080/00016489.2023.2265436. Epub 2023 Nov 8.

Abstract

BACKGROUND

The current treatment options for T1b glottic carcinoma often lead to poor treatment outcomes or voice quality.

OBJECTIVES

This study evaluates the therapeutic efficacy of horizontal middle partial laryngectomy with cricothyroidopexy (HMPL-CTP) for stage T1b glottic carcinoma.

MATERIAL AND METHODS

A retrospective analysis was conducted on 73 patients with T1b glottic carcinoma. The patients were categorized into three groups: Group A ( = 22) underwent transoral laser microsurgery (TLMS), Group B ( = 21) received frontolateral vertical partial laryngectomy (FVPL), and Group C ( = 30) underwent HMPL-CTP. The study analyzed the 5-year overall survival rate (OS), recurrence rate, phonatory status, and incidence of laryngeal stenosis.

RESULTS

Voice quality scores varied significantly in the three groups, while the 5-year OS were similar. The local recurrence rate is higher in Group A than in the other two groups. The laryngeal stenosis rate in Group B is higher than in Groups A and C. Adhesions in the anterior commissure were observed in 18 cases in Group A and nine cases in Group C.

CONCLUSIONS AND SIGNIFICANCE

HMPL-CTP demonstrates efficacy as a treatment for stage T1b glottic carcinoma, offering favorable preservation of laryngeal function and minimal complications.

摘要

背景

目前 T1b 声门型喉癌的治疗选择往往导致治疗效果不佳或嗓音质量下降。

目的

本研究评估环甲膜缝合水平部分喉切除术(HMPL-CTP)治疗 T1b 声门型喉癌的疗效。

材料和方法

回顾性分析了 73 例 T1b 声门型喉癌患者。将患者分为三组:A 组(n=22)接受经口激光显微手术(TLMS),B 组(n=21)接受前外侧垂直部分喉切除术(FVPL),C 组(n=30)接受 HMPL-CTP。分析了三组患者的 5 年总生存率(OS)、复发率、发音状态和喉狭窄发生率。

结果

三组患者的嗓音质量评分差异显著,而 5 年 OS 相似。A 组的局部复发率高于其他两组。B 组的喉狭窄发生率高于 A 组和 C 组。A 组有 18 例和 C 组有 9 例出现前联合粘连。

结论和意义

HMPL-CTP 是治疗 T1b 声门型喉癌的有效方法,能很好地保留喉功能,且并发症少。

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