Hanna E Y
Department of Otolaryngology-Head & Neck Surgery, University of Arkansas for Medical Sciences, Little Rock 72205.
Am J Otolaryngol. 1994 Sep-Oct;15(5):322-8. doi: 10.1016/0196-0709(94)90130-9.
In summary, subglottic tumors are fortunately uncommon. They tend to present late with extensive disease, and are difficult to assess clinically. CT and MRI can be helpful in this regard. They have a tendency for extra laryngeal spread and paratracheal lymph node metastases. Aggressive surgical therapy is therefore recommended. This usually includes a wide field laryngectomy, an adequate low tracheal margin, and bilateral paratracheal lymph node dissection. The thyroid gland should be removed on the ipsilateral side, and if there is evidence of gross invasion of the thyroid gland, total thyroidectomy should be performed. Postoperative radiation therapy is recommended to both sides of the neck, stoma, and upper mediastinum. This will hopefully reduce the risk of stomal recurrence.
总之，声门下肿瘤幸好并不常见。它们往往在疾病广泛时才出现较晚，且临床上难以评估。在这方面，CT和MRI可能会有所帮助。它们有向喉外扩散和气管旁淋巴结转移的倾向。因此，建议采用积极的手术治疗。这通常包括广泛的喉切除术、足够的低位气管切缘以及双侧气管旁淋巴结清扫术。应切除同侧甲状腺，如果有证据表明甲状腺有明显侵犯，则应进行全甲状腺切除术。建议对颈部两侧、造口和上纵隔进行术后放射治疗。这有望降低造口复发的风险。
