Lu Zhiyan, Li Changjiang, Chen Jian, Shu Min, Wang Yimiao, Li Dan, Chen Siyi, Ma Shuaichi, Cheng Lei, Wu Haitao, He Peijie
ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241301327. doi: 10.1177/19160216241301327.
Patients who undergo total laryngectomy lose the voice function permanently. It is important to reconstruct the voice function of the patients after total laryngectomy.
To explore a novel method for voice rehabilitation by suturing infrahyoid myocutaneous flaps to the hypopharyngeal and esophageal serosas after total laryngectomy and investigate its clinical efficacy.
Clinical study (retrospective study).
Twenty patients with advanced laryngocarcinoma who underwent total laryngectomy.
Following total laryngectomy, the pharyngeal cavity was formed via layer-by-layer suturing, and the infrahyoid myocutaneous flap was sutured to the common wall of hypopharyngeal and esophageal serosas to create a voice tube.
Flap failure was not observed in any patient. All patients were able to vocalize after surgery. The voice after the reconstruction was smooth and natural. However, 3 patients were unable to vocalize gradually. Two patients experienced aspiration, requiring the removal of the voice tube, while 3 patients exhibited mild aspiration, which could be overcome by pressing the larynx on the voice tube surface.
Using infrahyoid myocutaneous flaps with the common wall of the hypopharyngeal and esophageal serosas was effective in rehabilitating voice after total laryngectomy. Future clinical studies are necessary to validate the effectiveness of this technology for voice rehabilitation.
接受全喉切除术的患者会永久性丧失发声功能。全喉切除术后重建患者的发声功能很重要。
探索一种在全喉切除术后将舌骨下肌皮瓣缝合至下咽和食管浆膜以进行嗓音康复的新方法,并研究其临床疗效。
临床研究(回顾性研究)。
20例接受全喉切除术的晚期喉癌患者。
全喉切除术后,通过逐层缝合形成咽腔,并将舌骨下肌皮瓣缝合至下咽和食管浆膜的共同壁以形成声管。
所有患者均未出现皮瓣坏死。所有患者术后均能发声。重建后的声音平稳自然。然而,3例患者逐渐无法发声。2例患者出现误吸,需要拆除声管,3例患者出现轻度误吸,可通过按压声管表面的喉部来克服。
在全喉切除术后使用舌骨下肌皮瓣与下咽和食管浆膜的共同壁对嗓音康复有效。未来有必要进行临床研究以验证该技术对嗓音康复的有效性。