单蒂胸骨舌骨肌肌筋膜瓣在喉部分切除术中的应用

目的：探讨单蒂胸骨舌骨肌肌筋膜瓣在喉部分切除喉功能重建术中的应用价值。方法：对40例喉癌患者进行手术治疗，根据不同病变情况，采用相应的切除方式，以单蒂胸骨舌骨肌肌筋膜瓣重建喉功能。结果：患者均于术后10－20d拔除鼻饲管恢复正常饮食，无明显进食呛咳；均恢复正常语言交流，未出现喉腔闭锁发声失败者；31例于术后15d-6个月拔除气管套管，2例分别于术后2年和3年拔管，拔管率为82．5％（33／40）。3年生存率为86．6％，5年生存率为72．5％。结论：单蒂胸骨舌骨肌肌筋膜瓣适用范围较广，是喉部分切除喉功能重建较为理想的方法。

Uni-pedicled sternohyoid myofascial flap reconstruction of the larynx for partial laryngectomy

Objective:To observe the appliance value of uni-pedicled sternohyoid myofascial flap in laryngeal function reconstruction after partial laryngectomy.Method:Forty patients who underwent partial laryngectomy from 1981 to 1999 were summarized(male 36 cases, female 4 cases). Among them 19 were supraglottic carcinomas(T _2N _0 6,T _2N _2 1,T _3N _0 2,T _3N _1 1,T _3N _2 2,T _4N _0 4, T _4N _1 1,T _4N _2 2), 19 cases were glottic carcinomas(T _2N _0 6, T _3N _0 11,T _3N _2 2),2 cases were subglottic carcinomas(T _2N _0 1,T _3N _0 1). The choice of surgical procedure was decided on the pathologic conditions of the larynx, the laryngeal function was reconstructed using uni-pedicled sternohyoid myofascial flap.Result:Thirty-three cases were decannulated and recovered with laryngeal functions. The decannulation rate was 82.50%.All the patients rehabilitated deglutition in 10 to 20 days after surgery.None presented complication of aspiration. The 3-year survival rate was 86.58% and 5-year survival rate was 72.49%.Conclusion:The uni-pedicled sternohyoid myofascial flaps are appropriate for reconstruction of surgical defect in laryngeal carcinomas.