纤维喉镜下气管食管穿刺术及Provox发音钮植入的体会

目的 探讨采用纤维喉镜监察替代硬管食管镜或颈外径路进行气管食管穿刺及植入Provox发音钮的效果。方法 本文引述2例在纤维喉镜下进行二期气管食管穿刺术，2例分别在全麻及局麻下进行，植入Provox发音钮后，再以纤维喉镜检定位置。结果 2例术后能实时使用Provox发音钮发声，音色响亮清澈，并无不良反应。结论 纤维喉镜监察下进行气管食管穿刺术，准确性高，手术创伤小，对因手术或放疗引起颈项不能后仰的病人特别有利。

Tracheoesophageal puncture and Provox valve insertion under endoscopic guidance

Objective To demonstrate the usefulness of endoscopically guided tracheoesophageal puncture and Provox valve insertion, instead of using rigid oesophgoscopy or external approach. Methods Two cases of secondary tracheoesophageal puncture under endoscopic guidance with subsequent Provox valve insertion were reported. Patients were operated on under general and local anesthesia respectively. The final positions of Provox valves were inspected by flexible endoscopes. Results Both patients could use Provox valves to speak right after the surgery, the voice loud and clear. The operations were uneventful. Conclusion Endoscopically guided tracheoesophageal puncture is safe and accurate with minimal mobidity. It is particularly beneficial to the patients with stiff and fibrotic neck due to previous surgery or radiotherapy.