【摘要】 目的晚期喉癌行全喉切除发音重建及防误咽一直是头颈肿瘤外科攻关难题,研究气-食管通路发声重建防治误咽的新方法,评价对叠式气-食管通路发声口重建及檐状会厌成形术防治误咽的疗效。方法将纵形切开的气-食管漏行衣襟样对叠缝合;保留带蒂环状软骨瓣并修成会厌形状;在重建气-食管通路发声口上方将会厌形状骨片植入食道前壁粘膜下,使曲面向下凸入食管腔形成檐状会厌”。结果33例喉鳞癌术后3,7或12d拔除鼻饲管,经6～11d常规进食适应后均无误咽。随访2～5年,28例无发声口漏,2例癌复发肺、骨转移死亡,3例失访。结论对叠式气-食管通路发声口及“檐状会厌”有效地防治误咽。更多还原

【Abstract】 Aim To estimate the curative effect of vocal reconstruction of tracheaesophageal passway and the brim shape epiglottis plasty.Methods A pedicel cricoid cartilage flap had been built as well as the epiglottis after total laryngectomy.A downward concave face of the brim shape epiglottis above the phonatory opening from the posterior wall of the trachea and the anterior wall of the esophagus was made.Results The nasal feeding tube was pulled out 3,7 or 12 days after operation of larynx squamous carcinoma and there was no any patient with accidental aspiration after routine eating for 6 to 11 days.Of 33 cases undergoing this operation, 27 patients had not happened food aspiration, 2 cases died due to recurrence of the carcinoma, 3 cases failed to follow up.Conclusion We consider this method not only can avoid aspiration of the food but also is advantageous to the function of speech and swallowing in different degree.更多还原