Persky M S, Damiano A
Department of Otolaryngology, New York University School of Medicine, New York 10016, USA.
Ann Otol Rhinol Laryngol. 1998 Apr;107(4):297-300. doi: 10.1177/000348949810700407.
The extended vertical partial laryngectomy involves removal of the vocal cord and adjacent arytenoid cartilage. Arytenoid sacrifice predisposes the patient to postoperative aspiration, since adequate laryngeal closure during swallowing cannot be accomplished. Various techniques have been previously described for reconstruction of this defect. We present five patients who had reconstruction of this area with a local, mucosally based corniculate-cuneiform flap. All patients were decannulated, had no long-term aspiration, maintained socially acceptable voice quality, and had no tumor recurrence with a minimum of 3 years of follow-up. Our preliminary data suggest that this flap can be used in previously irradiated patients. The corniculate-cuneiform flap is an effective method of reconstruction in patients undergoing an extended vertical partial laryngectomy.
扩大垂直部分喉切除术包括切除声带及相邻的杓状软骨。切除杓状软骨会使患者术后易发生误吸，因为吞咽时无法实现充分的喉部闭合。此前已描述了多种用于修复该缺损的技术。我们报告了5例采用局部带蒂黏膜楔状会厌襞瓣修复该区域的患者。所有患者均拔除气管套管，无长期误吸，维持了社会可接受的嗓音质量，且至少随访3年无肿瘤复发。我们的初步数据表明，该皮瓣可用于曾接受过放疗的患者。楔状会厌襞瓣是扩大垂直部分喉切除术患者有效的修复方法。
