Leipzig B, Griffiths C M, Shea J P
Ann Otol Rhinol Laryngol. 1980 May-Jun;89(3 Pt 1):204-8. doi: 10.1177/000348948008900302.
A technique of primary neoglottic reconstruction for surgical restoration of voice following total laryngectomy is described in detail. This technique has been performed on 30 patients at the University of Texas Medical Branmch, and our results are reported. Twenty (67%) of these patients are speaking with their neoglottises after one year. Indications for neoglottic reconstruction are discussed, based on a review of the problems and complications which we have experienced. Relative contraindications to the procedure are extension of tumor beyond the anatomic boundaries of the larynx, patients with poor pulmonary reserve, or those with significant esophageal reflux incompetence. Radiotherapy is nt a contraindication to neoglottic reconstruction. It does predispose the patient to increased morbidity with spontaneous closure of the neoglottis, as well as aspiration, occurring occasionally. Other problems which are discussed include aspiration, postoperative wound infection, and patient compliance with the procedure. Results to date have been very encouraging, meriting further investigation of this one-stage vocal rehabilitation.
本文详细描述了一种用于全喉切除术后声音外科恢复的一期新声门重建技术。该技术已在德克萨斯大学医学分校对30例患者实施，现报告我们的结果。其中20例（67%）患者在术后一年能用新声门发声。基于对我们所经历的问题和并发症的回顾，讨论了新声门重建的适应证。该手术的相对禁忌证包括肿瘤超出喉的解剖边界、肺储备功能差的患者或有明显食管反流功能不全的患者。放疗并非新声门重建的禁忌证。放疗确实会使患者因新声门自发闭合以及偶尔发生的误吸而发病率增加。讨论的其他问题包括误吸、术后伤口感染以及患者对该手术的依从性。迄今为止的结果非常令人鼓舞，值得对这种一期声带康复方法进行进一步研究。
