喉环状软骨上部分切除术治疗喉声门上型癌

目的总结喉环状软骨上部分切除术治疗喉声门上型癌的疗效。方法对32例接受喉环状软骨上部分切除术(环状软骨舌骨固定术)治疗的喉声门上型癌病例进行随访和回顾性分析。结果本组T2、T3病例的3年生存率分别为85.7%(18/21)和66.6%(2/3),T2、T3病例的5年生存率分别为83.3%(5/6)和50%(1/2);所有患者术后都能发音,发音比较粗或沙哑,但能听懂;所有患者术后都有不同程度的误咽,经过练习96.8%的患者误咽克服,1例患者(3%)因术后始终无法克服误咽,改为喉全切除术;拔管率为100%。结论喉环状软骨上部分切除术手术操作简便,术后肿瘤学结果和功能结果满意,是治疗侵犯一侧或两侧声带的喉声门上型癌的有效术式。

Supracricoid partial laryngectomy in the treatment of supraglottic laryngeal carcinoma

OBJECTIVE To investigate the long termresults of supracricoid partial laryngectomy withcricohyoidopexy in the treatment of supraglottic laryn-geal carcinoma. METHODS A series of 32 cases ofsupraglottic laryngeal carcinoma operated since 1991were clinically followed up and the oncologic and func-tional results were retrospectively analysed. RESULTSThe 3 and 5 years survival rate were 83.3 %(20/24) and 75 %(6/8) respectively. The decannulation rate was 100 %. 96.8 %of the patients could finally take food by mouth withoutinspiration, while only one case (3 %) had to receive comple-tion laryngectomy as a result of food aspiration. All patientscould speak as soon as decannulated. CONCLUSIONSupracricoid partial laryngectomy with cricohyoidopexy isan oncologically effective operation with good preservationof laryngeal functions in the treatment of supraglottic laryn-geal carcinoma when one or both vocal cords are involved.