喉癌及下咽癌术后缺损前臂游离皮瓣修复发音重建

目的探讨前臂桡侧游离皮瓣修复喉及下咽癌术后缺损发音重建的手术方法及疗效。方法本组5例中喉癌3例，梨状窝癌2例，病理均为鳞状细胞癌。3例喉癌均行次全喉切除，2例梨状窝癌行同侧半咽及同侧3／4喉切除。5例均行患侧颈清扫术及前臂游离皮瓣修复发音重建。结果5例术后前臂游离皮瓣均成活。1例术后误咽明显，于术后9个月改行残喉切除永久气管造口术。余4例吞咽及发音功能良好，随访6～36个月均无肿瘤复发。结论应用前臂游离皮瓣修复喉及下咽癌术后缺损发音重建方法可行，安全、可靠。

Laryngeal function preservation and voice reconstruction in surgical treatment of free radical forearm flap for laryngocarcinoma and hypopharyngeal carcinoma

Objective To evaluate the application of free radical forearm flap transferred in surgical treatment of laryngocarcinoma and hypopharyngeal carcinoma for laryngeal function preservation mad voice reconstruction.Methods Of the 5 consecutive cases who recieved free radical forearm flaps,3 cases with laryngocarcinma were treated with near-total laryngectomy and 2 cases with pyriform sinus carcinoma were treated with homonymy demi-pharyngectomy and homonymy 3/4 laryngectomy.All cases were performed homonymy modifled-radical neck dissection.Results All the 5 free radial forearm flaps survived completely,without partial or total flap necrosis.One case was obvious aspiration and undergone leftover-laryngectomy and permanent trecheostomy after nine months,the other four cases swallowing and pronunciation function well,follow-up 6 to 30 months and without cancer recurrence.Conclusion In selected cases,the free forearm flaps is a preferable choice in reconstructive surgical procedure of laryngocarcinoma and hypopharyngeal carcinoma for laryngeal function preservation and voice reconstruction.