喉近全切除喉功能重建术

目的 为了减少喉全切除率并重建喉功能。方法 自１９９１￣１９９６年作喉近全切除喉功能重建术１９例。男８例，女１１例。年龄最大７４岁，最小４０岁，平均５７．６岁。临床分期Ⅱ期２例，Ⅲ期９例，Ⅳ期８例。手术特点是：切除舌骨，保留环状软骨及一侧杓状软骨，将五状软骨前缘与舌根切缘吻合，增强了舌根对新喉口的遮盖作用，减轻了误咽．结果 全部病例术后发音功能良好，多数病例误咽不重。５例拔除套管经喉呼吸。１４例新

Laryngeal reconstruction after near-total laryngectomy]

OBJECTIVE: To reduce the rate of near-total laryngectomy and reconstruct laryngeal function. METHOD: A retrospective review was made on 19 patients treated by near-total laryngectomy and laryngeal reconstruction from 1991 to 1996. Eight patients were male and 11 were female. The age range was from 40 to 74 years, with a mean age of 57.6. Two cases were in stage II, 9 cases stage III, 8 cases stage IV. The characteristic of this operation is to remove hyoid bone and reduce aspiration. RESULTS: Speech function in all patients was good. Deglutition in most patients was good. Five patients breathed through the larynx after decannulation. Fourteen patients respired through tracheostoma because of stenosis of laryngeal cavity. Among them, 10 cases did not need cannula for their wide tracheostomas, 4 cases needed cannula. Three-year survival rate was 78.6%(11/14), 5-year survival rate was 75%(3/4). CONCLUSION: Laryngeal reconstruction near-total laryngectomy is helpful to restore laryngeal function and decrease the rate of total laryngectomy.