颈阔肌肌筋膜及胸骨舌骨肌在喉重建中的临床应用  

The Application of Platysma Myofascial and Sternohyoid Muscle Flaps in Reconstruction of Larynox

作　　者：张少容[1] 罗璝[1] 熊科亮[1] 

机构地区：[1]江西医学院第二附院耳鼻咽喉科-头颈外科,江西南昌330006

出　　处：《江西医学院学报》2003年第1期98-99,共2页Acta Academiae Medicinae Jiangxi

摘　　要：目的 :探讨颈阔肌肌筋膜瓣及胸骨舌骨肌在喉重建中的临床应用价值。方法 :观察 2 8例喉癌患者 (声门型T2N0M0 )行垂直部分喉切除术后用颈阔肌肌筋膜瓣及胸骨舌骨肌修复喉缺损的临床效果。手术时根据癌肿的大小与部位行垂直部分喉切除术 ,根据缺损的大小 ,切制相应的带蒂颈阔肌肌筋膜瓣植入喉腔。用同侧的胸骨舌骨肌直接与残喉的甲状软骨外膜吻合修复缺损的甲状骨。结果 :全部病例均痊愈 ,喉腔内移植筋膜生长良好 ,喉腔无塌陷 ,未出现咽瘘 ,进食无呛咳 ,发音好。拔管率 96 .6 % ,3年生存率为 85 .7%。结论 :颈阔肌肌筋膜质地坚韧 ,取材方便 ,血供较好 ,是一种很好的修复材料 ;胸骨舌骨肌有一定的张力 ,不易塌陷 ,是修复部分甲状软骨缺损的好材料。Objective:To explore the clinical value of the platysma myofascial and sternohyoid muscle flaps in the reconstruction of larynx.Methods: 28 cases with Laryngocarcinoma were underwent the partial vertical laryngectomy and larynyeal reconstruction with platysma myofascial flap and sternohyoid muscle flap.According to the size and shape of laryngeal defect,a unipedicle platysma myofascial flap was taken and transposed into the lumen to cover the defect.Results:After operation, a three-year follow up indicated that the swallow function returned to normal in 7 to 10 days.The tracheal tube extraction rate was 96.6%(27/28) and 3 year survival rate was 85.7%(24/28).Conclusion:The playsma myofascial flap and sternohyoid muscle flap were feasible for laryngeal reconstruction.

关 键 词：喉重建术 喉癌 颈阔肌肌筋膜瓣 胸骨舌骨肌瓣 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]