喉大部分切除发音重建术

目的:探讨晚期喉癌、下咽癌喉大部切除后,喉发音功能的重建效果。方法:对我院自1994年4月～200O年4月的48例晚期喉癌、下咽癌患者,实行喉大部分切除发音重建术,观察他们的发音及误吸情况。结果:晚期喉癌、下咽癌在彻底切除病变的基础上,保留自身粘膜,形成发音管,发音及吞咽功能良好,无误吸现象。发音功能丧失率为10.49％,五年生存率为66.7％,1997年至今其中1例T_4N_3M_0患者因颈部淋巴转移而拒绝再治疗而死亡外,其余全部存活。结论:此术式适合于晚期喉癌、下咽癌,避免了其他发音装置的老化、经常更换及因咽缩肌的作用而致发音困难。手术时间短,方法简单易行。

Near-total laryngectomy and vocal function reconstruction

Objective: To explore the preservation of laryngeal vocal function after near-total laryngectomy for the advanced hypopharyngeal or laryngeal carinoma. Methods: Fourty-eight patients with advanced hypopharyngeal or laryngeal carcinoma were treated with near-total laryngectomy and vocal reconstruction from April 1994 to April 2000. The vocal function and pharyngeal fistula were observed. Results: The patients, who were treated near-total resection, retained part laryngeal mu-cosa and made vocal tube, have good functions of vocal and swallow, without pharyngeal fistula. The atretolemia rate of vocal tube was 10. 49% and 5-year survival rate was 66. 7%, since 1997, except one patient of T4N3M0 died of rejecting therapy, all are alive. Conclusion: This type of operation is adapt to advanced hypopharyngeal and laryngeal carcinoma. Its advantage comparing with using vocal applicance is no aging, avoiding replace frequently and no vocal difficulty by pharyngeal muscles. This kind of operation is simple and save time.