单侧胸骨舌骨肌骨瓣在部分喉切除术后整复中的应用

目的：评价单侧胸骨舌骨肌瓣带舌骨在喉癌喉部分切除术后整复中的效果，探讨其在喉癌喉部分切除术后整复中应用的适应证。方法：回顾性分析73例单侧胸骨舌骨肌瓣带舌骨整复的喉癌患者的临床资料，分别归纳统计手术后进食情况、气管套管拔管率、发声情况以及生存率等，并对不同术式的拔管情况进行统计学分析。结果：总体3年生存率为79．5％，所有患者术后均可拔除胃管经口进食，平均12．9d；气管套管的总体拔管率为76．7％，但各种术式的拔管率有所不同，扩大垂直半喉切除术的拔管率明显低于其他术式；83．6％以上的患者术后发声可以满足日常言语交流。结论：带舌骨的胸骨舌骨肌瓣整复喉癌术后的拔管率、发声和吞咽功能的恢复均较为理想，其中拔管率与手术的术式有关，此种方法扩大了喉癌的切除安全界，较好地保证术后生存率，对于病变范围侧重于一侧的T3-4；病例可以取代全喉切除，是一种应用性较强的喉癌术后整复方法。

Analysis of mono-side sternohyoid myo-osteal flap used in reconstruction after partial laryngectomy

OBJECTIVE: To evaluate the reconstruction effect and to investigate applied indicatio of unilateral sternohyoid muscle flap with hyoid bone in laryngeal carcinoma after pertial laryngectomy. METHOD: Seventy-three identified cases have been analysed by retrospective process. Statistic data mainly include postoperative eating condition, decannulation rate and postoperative voice. Detailed data of decannulation rate have been contrasted in different clinical stages, clinical types and operation types of malignant tumor. More data include three year, postoperative complications and so on. RESULT: There are about 79.5% cases survived three years or more. All the cases can take food by mouth without gastric tube after the operation, 12.9 days in average. The total decannulation rate is 76.7% and difference is found between enlarged-vertical hemilaryngectomy and the other types of operations. More than 83.6% patients can speak in a nearly normal way. CONCLUSION: The decannulation rate, voice and swallowing function are all recovoered satisfactory after the reconstruction and the decannulation rate is not influenced by clinical stage or else of laryngeal carcinoma, but only by the range of ectomy. The mono-side sternohyoid muscle flap with hyoid bone can restore a biggish defect of larynx, and the survival rate is satisfied. It can take the place of full laryngectomy in some T3 or T4 cases whose extent of disease laid particular emphasis on one side.