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用于全喉切除术后语音康复的带下咽和食管浆膜共同壁的舌骨下肌皮瓣。

Infrahyoid Myocutaneous Flaps with Common Wall of Hypopharyngeal and Esophageal Serosas for Voice Rehabilitation After Total Laryngectomy.

作者信息

Lu Zhiyan, Li Changjiang, Chen Jian, Shu Min, Wang Yimiao, Li Dan, Chen Siyi, Ma Shuaichi, Cheng Lei, Wu Haitao, He Peijie

机构信息

ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.

出版信息

J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241301327. doi: 10.1177/19160216241301327.

DOI:10.1177/19160216241301327
PMID:39698916
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11656418/
Abstract

IMPORTANCE

Patients who undergo total laryngectomy lose the voice function permanently. It is important to reconstruct the voice function of the patients after total laryngectomy.

OBJECTIVE

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.

DESIGN

Clinical study (retrospective study).

PARTICIPANTS

Twenty patients with advanced laryngocarcinoma who underwent total laryngectomy.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

重要性

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。

目的

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。

设计

临床研究（回顾性研究）。

参与者

20例接受全喉切除术的晚期喉癌患者。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/fdecbcac9226/10.1177_19160216241301327-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/83ac4eb240db/10.1177_19160216241301327-img2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/189afd476f55/10.1177_19160216241301327-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/108ff9695fab/10.1177_19160216241301327-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/fdecbcac9226/10.1177_19160216241301327-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/83ac4eb240db/10.1177_19160216241301327-img2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/189afd476f55/10.1177_19160216241301327-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/108ff9695fab/10.1177_19160216241301327-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c24/11656418/fdecbcac9226/10.1177_19160216241301327-fig3.jpg

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本文引用的文献

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Front Oncol. 2024 Jan 8;13:1284266. doi: 10.3389/fonc.2023.1284266. eCollection 2023.
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Has Esophageal Speech Returned as an Increasingly Viable Postlaryngectomy Voice and Speech Rehabilitation Option?食管语音是否已成为喉切除术后越来越可行的嗓音和言语康复选择？
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[The one-stage technology of epiglottis function and voice reconstruction after total laryngectomy with the sternohyoid myocutaneous flap].
[全喉切除术后应用胸骨舌骨肌皮瓣一期重建会厌功能及嗓音的技术]
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.
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Infrahyoid myocutaneous flap in head and neck reconstruction: a systematic review and meta-analysis.下咽颏舌肌皮瓣在头颈部重建中的应用：系统评价和荟萃分析。
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Comparing donor site morbidity between radial and ulnar forearm free flaps: a meta-analysis.桡骨和尺骨前臂游离皮瓣供区发病率的比较：荟萃分析。
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