声门上水平喉部分切除术应用55例

目的 评价声门上水平部分喉切除术的手术方法及远期疗效。方法 我科１９８６～１９９５年采用声门上水平部分喉切除治疗喉癌声门上型５５型，男３２例，女２３例，平均年龄５６岁，Ｉ期１１例，ＩＩ期２６例，Ⅲ期１１例，Ⅳ期７例。对声门上水平部分喉切除加以改进。用两侧梨状窝内侧壁粘膜缝合，封闭甲状软骨断面的后１／３，用甲状软骨外骨膜同喉室底壁粘膜缝合，封闭甲状软骨断面的前２／３，切除舌骨，将保留的甲状软骨同舌根

Supraglottic horizontal partial laryngectomy]

OBJECTIVE: To evaluate the long-term result of supraglottic horizontal partial laryngectomy. METHODS: Fifty-five patients with supraglottic laryngeal carcinoma were treated surgically by supraglottic horizontal partial laryngectomy from 1986 to 1995. There were 32 males and 23 females with an average age of 56. Eleven cases were staged I, 26 staged II, 11 staged III and 7 staged IV. Closure of the surgical defect begins by covering the thyroid cartilage with mucosa of the medial wall of the pyriform sinus. The outer perichondrium of thyroid cartilage was approximated with the mucosa of laryngeal ventricle. The hyoid cartilage was excised. The base of tongue was sutured to the reserved thyroid cartilage to take the place of epiglottic cartilage. RESULTS: The 3- and 5-year survival rates were 85% (47/55) and 77% (37/48) respectively. The decannulation rate was 96%. Most cases had acquired good speech and swallow function after 8-30 days. Complications included granulation and polyp formation at the base of tongue or at the anterior commissure in 4 cases. CONCLUSIONS: Supraglottic horizontal partial laryngectomy is very effective both in eradicating disease and in preserving laryngeal function.