全喉切除改良气管-咽吻合Ⅰ期发声重建术

目的：探讨全喉切除Ⅰ期发声重建术的改进术式。方法：采用低位气管切开，全喉切除，食管前壁黏膜重建声门，气管切口处造瘘．颈段气管上提并缩窄吻合于舌根的方法行全喉切除及Ⅰ期发声重建木35例。结果：33例(94．29％）术后获得了不同程度的发声功能．不能发声者仅2例(5．71％)。全部患者术后均可经口进食，未出现严重的影响生存质量的误咽。结论：与以往的发声重建术相比，本术式具有发声成功率高、发声质量良好、误咽率低等优点，且无须置人人工发声装置．值得推广。

First stage speech reconstruction after total laryngectomy with the improved trachea-pharynx anastomosis

Objective:To investigate the improved methods of first stage speech reconstruction after total laryngectomy.Method:We improved the method of the first stage speech reconstruction after total laryngectomy with a low level tracheotomy, reconstruction of the glottis with the ahead mucous membrane of esophagus, making stoma at the incision of trachea, lifting and shrinking the cervical trachea and sewing up to the root of tongue. This novel method was adoptioned on 35 patients, the curative effect had been observed.Result:Among the 35 patients, 33 patients( 94.29 %)regained the phonation function to a different extent. Only 2 patients ( 5.71 %) could not speak. Most patients got an articulate and fluent voice. All of the patients could take food by mouth without severe miss deglutition.Conclusion:There are many excellences in our operation style. The success rate of the speech is higher, the quality of the speech is better and the rate of the miss deglutition is lower than the classical operation style of the speech reconstruction. It has no use for a factitious speech device and deserves to spread.