喉声门上水平部分切除术的术式改良

目的探讨喉声门上水平部分切除术的手术方法改良及远期疗效。方法回顾并分析了我科1983～2001年喉声门上型癌172例，男149例，女23例。进行喉声门上水平部分切除后不将喉上提，不做残喉与舌骨或舌根的吻合。结果气管套管拔除率为92．4％，吞咽功能142例在2～4周内恢复，发音功能良好。3年存活率为82．6％；5年存活率为75．7％。结论喉肿瘤切除后，改变缝合方法，不仅操作简单，又能保留良好的生理功能。

Laryngeal function reconstruction after supraglottic horizontal partial laryngectomy

OBJECTIVE To modify the method of laryngeal closure after supraglottic horizontal partial laryngectomy. METHODS 172 cases with supraglottic laryngeal cancer ,from 1983 to 2001, were analysed retrospectively ,of whom 149 were males ,23 were females. We performed some modification on the method of closure of the wound after supraglottic hori- zontal partial laryngectomy. The surgical defect of thy- roid cartilage was covered by approximating the outer perichondrium of thyroid cartilage to the mucosa of the laryngeal cavity . The remaining thyroid cartilage was not sutured to the hyoid bone or the base of the tongue- as usual. RESULTS The 3year or 5year survival rate of the patients was 82.6% or 75.7% respectively. Decannulation rate was 92.4%, and 142 cases resumed their swallow function within 2-4 weeks ,and most of the cases attained a good speech ability . CONCLUSION This modified technique is simpler in preserving laryngeal physiologic function after supraglottic horizontal resec- tion of the laryngeal cancer.