会厌瓣在下咽—颈段食管一期重建术中的应用

报告下咽癌切除术后，应用会厌剖开延伸的粘软骨膜瓣修复下咽颈段食管的粘膜缺损8例，术中分别采用会厌瓣和胸骨舌骨肌筋股瓣、会厌瓣和残存下咽粘膜瓣作复合修复，术后恢复良好的吞咽功能，无咽颈瘘发生．临床上虽可应用胃、空肠、结肠和胸大肌肌皮瓣代下咽颈段食管，但手术费时、复杂、病人痛苦大。本术式优点：就近取材，血运丰富，操作简便，成功率高，并发症少。

Reconstruction of the hypopharyngeal and cervical esophagus using flap of epiglottis

Reconstruction of the hypopharyngeal and cervical esophagus was performed for eight patients after the resection of hypopharyngeal carcinoma. The flap of the epiglottis and the facial flap of the sternohyoid muscle or the uninvolved mucous membrane of the hypopharynx were used for the reconstruction of the fhypopharyngeal and cervical esophagus. A good swallowing function was obtained. No pharyngeal-cervical fistula occurred. Although stomach transposition or colon interpolation and pectoralis major myocutaneous flap could be used to reconstruct the hypopharynx and the cervical esophagus, however, the operative time became longer, more complex and the patient suffered more. The procedure of the nap of epiglottis had the following advantages: (1 )a rich vascularized flap ; (2)simple operative technique; (3)higher success rate ;and (4)few complications.