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次全喉切除双颈阔肌皮瓣喉重建术的临床应用

Subtotal laryngectomy reconstructed by platysma myocutaneous flaps

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【作者】 伍国号; 陈福进; 李庆端; 李浩; 王雅超; 魏茂文; 许光普; 冯愉态;

【Author】 WU Guohao *, CHEN Fujin, LI Qingduan, et al. *Department of Head and Neck Surgry, Tumor Hospital, Sun Yat sen University of Medical Sciences, Guangzhou 510060, China

【机构】 广州中山医科大学肿瘤防治中心头颈科; 广东武警总医院耳鼻咽喉科; 广东电白县人民医院耳鼻咽喉科; 广东电白县人民医院耳鼻咽喉;

【摘要】 目的 探讨T4声门区喉鳞状细胞癌次全喉切除双颈阔肌皮瓣喉重建术临床应用的可行性、技术操作及疗效。方法 选择 13例T4声门区喉鳞状细胞癌施行次全喉切除双颈阔肌皮瓣喉重建术。结果  13例患者术后发音成功率为 10 0 % ,其中 11例言语可接受度达 7级 ,言语可理解度为95 %以上 ,余 2例言语可接受度为 5级 ,言语可理解度为 90 %以上。误咽发生率为 15 .4% (2 / 13)。 3年复发率为 2 3.1% (3/ 13) ,3年、5年生存率分别为 84.6 % (11/ 13)和 76 .9% (10 / 13)。结论 该术式扩大了常规次全喉切除术的适应证 ,有效地恢复喉的全部功能 ,提高患者术后生存质量 ,值得推广应用

【Abstract】 Objective To study the feasibility, surgical techniques and the results of laryngeal function preservation during subtotal laryngectomy in laryngeal carcinoma. Methods A retrospective review was made of 13 patients treated by subtotal laryngectomy and laryngeal reconstruction from 1991 to 1996. Eleven patients were male and 2 were female. The age ranged from 46 to 72 years, with a mean of 53.25. All cases were of stageⅣ. The essence of this operation is to reconstruct the new larynx with two platysma myocutaneous flaps following subtotal laryngectomy. Results The success rate of voice rehabilitation was 100%. Among them, the acceptability rating scores in 11 cases were 7 and the intelligibility scores ranged from 95% to 98%. The other two cases had acceptability 5 and intelligibility form 90% to 94%. The three year survival rate was 84.6% (11/13), 5 year survival rate was 76.9% (10/13). Conclusion This form of laryngeal reconstruction in subtotal laryngectomy is helpful to restore laryngeal function and decrease the rate of total laryngectomy. The procedure is easy, safe and applicable to patients treated by subtotal laryngectomy.

【关键词】 喉肿瘤; 喉切除术; 外科皮瓣;
【Key words】 Laryngeal neoplasms; Laryngectomy; Surgical flaps;
  • 【文献出处】 中华耳鼻咽喉科杂志 ,Chinese Journal of Otorhinolaryngology , 编辑部邮箱 ,2001年03期
  • 【分类号】R739.65
  • 【被引频次】8
  • 【下载频次】40
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