双侧声带水平切除治疗双侧声带癌

目的 探讨治疗双侧声带癌保留发声功能的手术治疗方法。方法 回顾性分析1990年1月～2001年8月行声带水平切除治疗的5例双侧声带癌患者的临床资料。根据UICC 1987 TNM分期标准，双侧T2NoMo1例，一侧T2NoMo，另一侧T1NoMo4例；病理诊断为鳞状细胞癌：行水平切除双侧声带及下半甲状软骨板，保留甲状软骨膜，上提环状软骨，将甲状软骨板外膜与环甲膜缝合，关闭术腔，周围用颈部带状肌缝合加固。结果 随访5年以上3例，1年以上2例。1例手术后5年死于肺癌，其它4例现仍生存。术后全部拔管，吞咽正常，声音低沉但可正常交谈。1例术后伤口感染，经治疗而愈。结论 声带水平切除治疗双侧声带癌可以一期切除肿瘤及周围受浸润组织，利用双侧室带代替声带发声，环状软骨上提形成支架建立呼吸通道，提高了术后生存质量。

Bilateral Level Glottectomy For Bilateral Glottic Carcinoma

Objective To evaluate the effects of level glottectomy for bilateral glottic carcinoma.Methods Five patients with bilateral vocal cord carcinoma were retrospectively reviewed according to UICC1987 criteria and the pathologic findings showed squamous cell carcinoma. One patient was in T 2NoMo of both sides.Four patients were T 2NoMo of one side and T 1NoMo of the other side. All five patients were treated with level glottectomy and functional neck dissection with removing the inferior part of thyroid cartilage.Results Three cases survived for over 5 years after the operation and two for 2 years.1 patient died of lung cancer five years after operation .The laryngeal function was well preserved. There was only one patient with complication of pharyngeal fistulas.Conclusion Compared with totle laryngectomy, lever glottectomy to treat bilateral vocal cord carcinoma can resect tumor completely and improve the life quality of patient after surgery.