黏膜管成形一期发音功能重建在晚期喉癌手术中的应用

目的 研究晚期喉癌切除一期发音功能重建.对失去喉部分切除机会的晚期喉癌患者用黏膜管成形法进行一期发音功能重建术.方法 1991年10月至2006年5月共行手术46例,男41例,女5例,平均年龄54岁.声门型喉癌17例,其中T3N0M0 12例,T3N1M0 5例;声门上型喉癌27例,其中T3N1M016例,T4N1M05例,13NOM06例;梨状窝癌2例,均为T4NI M0,侵及喉部并累及对侧.手术仅保留一侧残余杓状软骨并摘除,利用残余黏膜与延续到气管的黏膜瓣和下咽部黏膜缝合成黏膜管而重建发音功能.结果 46例患者有41例取得了良好的发音效果而无误咽.Kaplan-Meier法计算5年生存率为76%.结论 黏膜管成形法重建发音功能可使部分晚期喉癌患者在喉切除后用自身材料一期发音功能重建而取得较理想的发音和吞咽功能.

Applied study of voice function rehabilitation by mucosa tube performed in operation of late laryngocarcinoma

Objective To study the voice function rehabilitation by mucosa tube performed in operation of late laryngocarcinoma and to improve the survival quality of patients with Iate laryngocarcinoma.Methods Forty-six patients were treated between Oct.1991 and May 2006,including 4l males and 5females.The average age of the patients Wa8 54.Seventeen cases were glottic carcinomas(T3 NOM0 12,T3NIM0 5),27 cases were supraglottic carcinomas(T3N1M0 16,T4N1M0 5,T3N0M0 6),2 cases were pyriform sinus cancer(T4NlM0 2).For those patients with late laryngocarcinoma, who had lost the chance of partial laryngectomy, mucosa tube shaping during the operation could realize voice functional rehabilitation. Only the survive arytenoids of healthy side was preserved, in order to rehabilitate voice, amucosa tube Was sutured using healthy survive arytenoids and a mucosa strip Was connected to the trachea and the mucosa of hypopharynx. Survival analysis was performed by using Kaplan-Meier method. Results Forty-one out of 46 patients obtained almost normal voice and swallow function. The 5-years survival was76%.Conclusions The operation of voice function rehabilitation by mucosa tube performed can get good voice and swallow function to patients with late laryngo carcinoma.