喉切除重建“会厌”防止发声口的误咽  

Prevention and treatment for aspiration of tracheaesophageal shunt phonatory opening

作　　者：蒋立新[1] 

机构地区：[1]葫芦岛市中心医院耳鼻咽喉科,辽宁葫芦岛125001

出　　处：《临床耳鼻咽喉科杂志》2002年第5期225-226,共2页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :探讨全喉切除防止气管 食管通路发声口误咽的方法。方法 :对 2 6例喉鳞癌患者行全喉切除 ,保留带蒂环状软骨瓣并修成会厌形薄片 ;改良气管 食管通路发声口 ;将会厌形骨片固定在发声口上方形成“檐状会厌” ;缝合气管断端并向后挤压“檐状会厌”凸入食管腔中。结果 :2 6例在术后 3、7或 12d拔除鼻饲管 ,经6～ 11d常规进食适应后均无误咽。随访 2～ 5年 ,2 1例无误咽 ,3例失访 ,2例癌复发。结论 :环状软骨瓣重建“檐状会厌”能有效防止全喉切除术后气管 食管通路发声口的误咽。Objective:Estimating the curative effective of the brim shape epiglogttis plasty.Method:A pedical cricoid cartilage flap has been built as well as the epiglogttis after total laryngectomy, a downward concave face of the brim shape epiglogttis above the phonatory opening from the posterior wall of the trachea and the anterior wall of the esophagus was made.Result:Of 26 cases undergoing this operation, 21/26 patients have not happened food aspiration, 2/26 cases died due to recurrence of the carcinoma, 3/26 cases missing connection following 2.0 ～ 5.0 years. Conclusion:We consider this method not only avoided aspiration of the food but also is advantageous to the function of speech and swallowing in defferent degree.

关 键 词：喉肿瘤 喉切除术 会厌成形术 误咽 

分 类 号：R739.65[医药卫生—肿瘤] R730.56[医药卫生—临床医学]