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环状软骨后区癌手术治疗中的嗓音保留技术

Voice preservation technique in the surgical treatment of postcricoid cancer.

作者信息

Takemiya S, Shimada F, Omura K

出版信息

Auris Nasus Larynx. 1985;12 Suppl 2:S48-51. doi: 10.1016/s0385-8146(85)80028-6.

Abstract

In patients with freedom from invasion to anterior half of the larynx in postcricoid and cervical esophageal cancer, reconstruction of vocal tract with preservation of the anterior half of the larynx is applied with oncologic rationality and we performed the procedure in three cases of T2N1. At neck dissection bilateral superior thyroid neurovascular pedicles and unilateral inferior thyroid vessels were preserved. The larynx and upper part of the trachea were devided on the frontal plane and the posterior half with the hypopharynx and cervical esophagus was removed. The anterior half of the part was preserved and the mucosal edges of the cut surface extending from the appropriate margin of membranous portion of the trachea to the aryepiglottic folds were longitudinally approximated to reconstruct a thin tube to rehabilitate the voice. The pharyngoesophagus was replaced by either deltopectoral flap or forearm flap. Postoperative aspiration was minimal and voice rehabilitation was satisfactory.

摘要

对于环后区和颈段食管癌未侵犯喉前半部分的患者,采用保留喉前半部分的声道重建术具有肿瘤学合理性,我们对3例T2N1患者实施了该手术。在颈部清扫术中,保留双侧甲状腺上神经血管蒂和单侧甲状腺下血管。在额平面将喉和气管上部切断,切除后半部分连同下咽和颈段食管。保留前半部分,将从气管膜部适当边缘至杓会厌襞的切面黏膜边缘纵向对合,重建细管以恢复发声。咽食管用胸大肌三角肌皮瓣或前臂皮瓣替代。术后误吸轻微,发声功能恢复满意。

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