扩大部分喉切除颈前肌皮瓣喉重建术临床观察

目的　探讨颈阔肌双蒂转门肌皮瓣在喉重建术中的临床应用价值。方法　对 38例喉癌行扩大部分喉切除术 ,包括扩大垂直喉切除术 2 7例 ,扩大额侧喉切除术 7例 ,次全喉切除术 4例 ,应用颈阔肌双蒂转门肌皮瓣同期进行缺损喉腔重建 ,结果　本组病例术后气管套管拔除率为 92 1% ( 35 /38) ,全部患者恢复了发音功能 ,语言响亮清晰者 95 0 % ( 36/38) ,吞咽防护功能全部恢复 ,局部复发率 7 9% ( 3/38) ,3年生存率 89 5 % ( 3/38)。结论　中晚期喉癌选择性地施行功能保全性喉手术是可行的 ,应用转门肌皮瓣进行缺损喉腔重建可获得满意的喉功能恢复效果

The Clinical Observation for Reconstruction of New Larynx by Myocutaneous Flap of Neck Fascicle Lata in Extended Partial Laryngectomy

Objective The purpose of this study is to present the valuation of clinical practice for reconstruction of new larynx by myocutaneous flap of neck fascicle lata in extended partial laryngectomy.Methods Thirty eight cases of Laryngeal carcinoma were treated by extended vertical laryngectomy(27/38),extended frontolateral laryngectomy(7/38) and subtotal laryngectomy(4/38);the defects of larynx were reconstructed by rotary door myocutaneous flaps for all these patients.Results Decannulation rate was 92.1%(35/38),All cases resumed acceptable voice,95.0%(36/38) and enjoyed satisfactory phonation.All the patients had normal swallow function.The survival rate of 3-year was 89.5%(4/38).Conclusions Extended Partial Laryngectomy is a kind of radical operation in selected cases of Laryngeal carcinoma.The mothod of reconstruction with rotary door myocutaneous flaps can improve curative effect and the essential functions of the larynx.