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甲状腺软骨开窗与拉出切除术联合钛微型钢板内固定重建喉功能治疗早期声门癌:一种新颖且有效的手术方法

Reconstruction of laryngeal function by thyroid cartilage fenestration and draw-out resection followed by internal fixation with titanium microplates for early glottic carcinoma: a novel and efficient surgical approach.

作者信息

Li Yahong, Ruan Shenjiong, Hong Yuming, Zhuang Feiyi, Zheng Chaohui, Lu Ming, Chen Xiaofang

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China.

出版信息

Am J Transl Res. 2024 Jun 15;16(6):2589-2598. doi: 10.62347/ATPE6857. eCollection 2024.

DOI:10.62347/ATPE6857
PMID:39006276
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11236634/
Abstract

OBJECTIVE

To explore the clinical effectiveness of reconstructing laryngeal function using thyroid cartilage fenestration and "draw-out" resection, supplemented by internal fixation with titanium microplates in early glottic carcinoma.

METHODS

Data from 99 patients with glottic carcinoma treated in the Second Affiliated Hospital of Fujian Medical University between January 2014 and September 2021 were retrospectively analyzed. Forty-eight patients who underwent thyroid cartilage fenestration and resection followed by internal fixation with titanium microplates for laryngeal function reconstruction were assigned to the thyroid cartilage fenestration group (TCF group), while the other 51 patients who underwent sternohyoid muscle and fascia repair for laryngeal function reconstruction were assigned to the sternohyoid muscle repair group (SMR group). Patients were followed up for 1-8 years. Data on postoperative phonatory function, respiratory function, swallowing function, and survival status were collected.

RESULTS

Compared to the SMR group, patients in the TCF group showed better postoperative recovery in phonatory function and verbal communication (all P<0.05). In the TCF group, patients demonstrated stable respiration and the extubation rate was 100.00%, which was significantly higher than 82.35% in the SMR group (P<0.05). Patients in both groups showed good postoperative recovery of swallowing function (P>0.05).

CONCLUSION

One-stage reconstruction of laryngeal function by thyroid cartilage fenestration and "draw-out" resection with adjuvant internal titanium microplate fixation in early glottic carcinoma demonstrates good postoperative recovery and good preservation of the laryngeal function.

摘要

目的

探讨采用甲状软骨开窗及“拉出”切除术重建喉功能,并辅以钛微型钢板内固定治疗早期声门癌的临床疗效。

方法

回顾性分析2014年1月至2021年9月在福建医科大学附属第二医院接受治疗的99例声门癌患者的数据。48例行甲状软骨开窗及切除,随后采用钛微型钢板内固定进行喉功能重建的患者被分配到甲状软骨开窗组(TCF组),而另外51例行胸骨舌骨肌及筋膜修复进行喉功能重建的患者被分配到胸骨舌骨肌修复组(SMR组)。对患者进行1至8年的随访。收集术后发声功能、呼吸功能、吞咽功能及生存状况的数据。

结果

与SMR组相比,TCF组患者术后发声功能及言语交流恢复更好(均P<0.05)。TCF组患者呼吸稳定,拔管率为100.00%,显著高于SMR组的82.35%(P<0.05)。两组患者术后吞咽功能恢复均良好(P>0.05)。

结论

早期声门癌采用甲状软骨开窗及“拉出”切除术并辅以钛微型钢板内固定进行一期喉功能重建,术后恢复良好,喉功能保留效果佳。

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