环舌骨会厌固定术后的喉形态学研究及其影响因素分析  

The morphplogical and its influencing factors research after supracricoid partial laryngectory with cricohyoidoepiglottopexy

作　　者：赵峰[1] 黄小英[1] 苏纪平[1] ZHAO Feng;HUANG Xiaoying;SUJiping(Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guan-gxi Medical University,Nanning,530021,China)

机构地区：[1]广西医科大学第一附属医院耳鼻咽喉头颈外科,南宁530021

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第20期1584-1587,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:了解环舌骨会厌固定术(SCPL-CHEP)术后新喉形态和运动特点,探讨影响新喉形态学的相关因素。方法:选取SCPL-CHEP术后的46例喉癌患者作为研究对象,所有患者均行动态喉镜检查,观察新喉发声时的运动情况(声门关闭和声门振动情况),结合患者临床资料,分析可能影响新喉发声形态及运动特点的相关因素。结果:46例行动态喉镜检查的SCPL-CHEP术后患者中,发声时声门关闭完全31例(67.4%),关闭不全15例(32.6%);声门上结构振动33例(71.7%),声门上结构无振动13例(28.3%);Spearman's相关性分析表明,声门关闭状态与年龄、肿瘤分型呈正相关(r=0.313,P=0.034;r=0.592,P=0.000),与术后时间呈负相关(r=-0.446,P=0.002);声门上结构振动情况与术后放疗呈负相关(r=-0.393,P=0.007);结论:SCPLCHEP术后新喉形态多样,解剖结构明显改变,发声时存在不同程度关闭不全和多种结构参与的不规则振动;患者年龄、肿瘤分型、术后时间是影响声门关闭状态的相关因素,声门上结构振动与术后放疗密切相关。Objective：The aim of this study for observing laryngeal morphology,and motion characteristics after supracricoid partial laryngectomy with cricohyoidoepiglottopexy（SCPL-CHEP）,exploring the relevant factors affecting the morphology of new laryngeal.Method：Choose 46 cases of patients with laryngeal cancer for SCPLCHEP as the object of study,dynamic laryngoscope were performed in all the patients,to observe the movement of laryngeal pronunciation（neoglottis closure,supraglottic situation）.Combined with the patient＇s clinical data,the relevant factors that may affect the pronunciation and movement characteristics of the new throat were analyzed.Result：46 patients after SCPL-CHEP were included in the study.The neoglottis completely closed in 31 cases（67.4%）,insufficiency closed in 15 cases（32.6%）.Supraglottic vibration in 33 cases（71.7%）,13 cases（28.3%）of supraglottic structure vibration free.The Spearman＇s analysis showed that,neoglottal closure status was positively correlated with age and subglottic lesions（r=0.313,P=0.034;r=0.592,P=0.000）,and negatively correlated with the postoperative time（r=-0.446,P=0.002）.The supraglottic vibration was negatively correlated with postoperative radiotherapy.Conclusion：The anatomy of neolarynx changes greatly,the function of neolarynx only depends on the movement of he remaining cricoarytenoid unit and arytenoid mucosa vibration.The age,tumor type,and postoperative time are related factors that affect glottic closure.Postoperative radiotherapy can reduce the occurrence of supraglottic vibration.

关 键 词：喉肿瘤 环舌骨会厌固定术 声门关闭 声门上振动 形态学 

分 类 号：R739.65[医药卫生—肿瘤]