晚期喉癌喉全切除后发音重建安装发音钮术5例

目的探讨晚期喉癌喉全切除后发音重建安装发音钮术,以提高发音效果。方法分析我科自2002年2月至2006年9月开展的5例Blom-Singer发音钮安装经过,并结合文献进行了讨论。结果使用第二代低压式Blom-Singer发音钮,Ⅰ期安装发音钮4例,Ⅱ期安装1例。5例患者术后发音均获得成功,均能流畅交谈,言语清晰可辨。结论目前安装发音钮是喉全切除后病人语言康复治疗的首选方法;对喉全切除的病人,不管是否要安装发音钮,探查食管入口有括约感者均应切断环咽肌;Ⅱ期安装发音钮应在全麻下进行,以减轻病人的痛苦;个人对发音钮装置的维护十分关键,能明显影响其使用寿命;只要肿瘤未累及食管入口,喉全切除术后能利用残余组织进行无张力的下咽修复,均可行安装发音钮术。

Phonatory button installation after total laryngectomy in carcinoma of larynx in later period

Objective To explore to voice rehabilitation and phonatory button installation after total laryngectomy in carcinoma of larynx in later period,in order to improve the result of pronouncing.Methods 5 cases installed Blom-Singer buttons were analyzed in our hospital from September,2006 to February,2002,and they were discussed with new documents.Results Using the second generation of low-voltage type Blom-Singer button,four cases were inserted on during the first stage,one case after the second stage.They all can smooth to talk,which their spoken language can be distinguished clearly,their audio-visual information left in our department.Conclusion To install voice button is the first-slected method to recover language at present after total laryngectomy.In surgery we should ascertain the esophagus entrance to have or not sphincteral feeling,which having it,cricopharyngeal muscle should be cut off.The patient installed voice button in the second stage should be carried on under the general anesthesia to lighten the patient's agony.Being very crucial to the maintenance of the phonatory button device,individual can obviously influence its service life.So long as the esophagus entrance has not been involved,after total laryngectomy we can utilize the remaining tissue to make the tension-free repair of hypopharynx,the phonatory button installation technique on the patient is feasible.