舌骨肌瓣联合改良会厌瓣在晚期喉癌喉重建的应用

目的探讨晚期喉癌喉行喉部分切除术后喉功能重建的方法。方法对有选择性的16例T3、T4期喉癌患者行垂直侧前位喉次全切除（10例）或水平垂直部分喉切除术（6例），同期采用舌骨肌瓣联合改良会厌瓣进行喉功能重建。结果随访3—5年，3年存活率为87．5％（14／16）、5年存活率为66．6％（6／9），气管套管拔除率为87．5％（14／16），发音功能及吞咽保护功能完全恢复。结论晚期喉癌选择性施行喉功能保全性手术可行，采用舌骨肌瓣联合改良会厌瓣进行喉功能重建能有效恢复喉功能。

Application of hyoid muscular flap combining with modified epiglottis flap in laryngeal function reconstruction for advanced laryngocarcinoma

Objective To investigate the method of laryngeal function reconstruction after partial laryngectomy for advanced laryngocarcinoma.Methods Subtotal laryngectomy with vertical latero-anteposition was performed in 10 selected T3~T4 patients,and horizon-vertical partial laryngectomy was performed in the other 6 cases.Laryngeal function reconstruction with hyoid muscular flap combining with modified epiglottis flap was carried out at the same time.Results All cases were followed up for 3 to 5 years,with 3 year survival rate of 87.5%(14/16)and 5 year survival rate of 66.6%(6/9).87.5%(14/16)of tracheal cannula were pulled out,the voiced function and swallowing protection function were completely recovered.Conclusions Larynx function reserved operation was feasible for selected advanced laryngocarcinoma.Reconstruction applying hyoid muscular flap combining with modified epiglottis flap could restore the larynx function effectively.