喉癌甲状软骨内膜下切除及健侧甲状软骨外膜瓣修复术的治疗效果  

Removal of laryngeal cancer with thyroid cartilage membrane excision and repair of laryngeal cavity with outside thyroid cartilage membrane flap of healthy side： oncologic and functional outcomes

作　　者：钟兆棠[1] 梁敏志[1] 陈泽[1] 

机构地区：[1]高州市人民医院耳鼻喉科,广东茂名525200

出　　处：《中华耳鼻咽喉头颈外科杂志》2016年第8期611-614,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 探讨通过患侧甲状软骨内膜下切除结合健侧甲状软骨外膜瓣修复喉腔的术式治疗喉癌的治疗效果及可行性.方法 对高州市人民医院耳鼻喉科于2005-2011年确诊的28例喉癌患者,均采用患侧甲状软骨内膜下切除结合健侧甲状软骨外膜瓣修复喉腔的术式进行手术;并随访至5年,观察患者术后呼吸功能、吞咽功能、发音、复发及生存率.结果 该术式治疗喉癌患者拔管率96.4％ （27/28）;误咽率10.7％（3/28）,但均通过吞咽训练完全恢复;术后所有患者都存在不同程度声嘶,但均可对话交流;肿瘤复发3例,其中l例为原位复发,2例为颈部淋巴结转移复发,肿瘤复发率为10.7％（3/28）;3、5年累积生存率分别为89.3％和85.7％.结论 患侧甲状软骨内膜下切除结合健侧甲状软骨外膜瓣修复喉腔的术式适用于部分T2期喉癌;并能较完整地保留了喉的骨架及喉生理功能,修复组织稳定,利于发音,不易引起喉狭窄,具有可行性.Objective To study the efficacy and feasibility of removal of laryngeal cancer with thyroid cartilage membrane excision and repair of laryngeal cavity by the outside thyroid cartilage membrane flap of healthy side. Methods A total of 28 patients were reviewed who underwent the removal of laryngeal cancer with thyroid cartilage membrane excision combined with the repair of laryngeal cavity by the outside thyroid cartilage membrane flap in our hospital between 2005 and 2011. Respiratory function, swallowing function, and voice quality of patients after surgery were evaluated. Survival and recurrence were observed with the follow up of five years. Results The decannulation rate was 96.4%. Aspiration rate was 10.7%, but aspiration was completely revolved by swallowing training in the patients. All patients had the voice quality required for communication although they complained of hoarseness after surgery. Tumor recurrence was found in one patient and cervical lymph node metastasis in 2 patients. The three-year and five-year survival rates were 89.3% and 85.7% respectively. Conclusion This surgical procedure was applicable in some of patients with T2 laryngeal cancer, with good laryngeal functions after surgery.

关 键 词：喉肿瘤 甲状软骨 修复外科手术 

分 类 号：R739.65[医药卫生—肿瘤]