肩胛舌骨肌瓣修复喉部分切除术后缺损  

Study on post-laryngectomy partial laryngeal defect repaired with omohyoid myofascial flap

作　　者：宋建京 王其友[1] 王侠[1] 曲衍学 秦志文 李吉洲 王培成[1] 张建新[1] 

机构地区：[1]威海市立医院耳鼻咽喉科,山东威海264200 [2]荣成市第二人民医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉科杂志》2003年第9期519-521,共3页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :探讨肩胛舌骨肌瓣修复喉部分切除术后缺损的可行性和临床疗效。方法 :对 2 4例声门上型、声门型喉癌患者切除肿瘤和受累的软骨 ,以肩胛舌骨肌瓣修复组织缺损、重建声门。对于一侧杓状软骨固定患者 ,切除杓状软骨 ,在取肩胛舌骨肌瓣同时连带切取一小块舌骨 ,将小舌骨块固定于杓状软骨缺损处 ,用残余黏膜覆盖之。声门上型T2 、声门型T3 以上患者术后接受放射治疗 (5 0～ 6 0Gy)。结果 :随访 1～ 5年 ,1例声门上型(T3 )患者于术后 2年 9个月死于局部复发 ,1例声门型 (T3 )患者于术后 4年 3个月死于颈部转移和骨转移。拔管率为 95 .8%。 91.7%的患者发声近乎正常或声哑。吞咽功能全部恢复。结论 :经过仔细选择病例 ,肩胛舌骨肌瓣修复喉部分切除术后缺损、重建声门是积极有效和切实可行的。Objective:To explore the clinical effect on defect of post-laryngectomy partial laryngeal repaired with omohyoid myofascial flap.Method:Twenty-four cases of supraglottic and glottic cancer were treated surgically.The tumors and involved cartilages were removed entirely. The omohyoid myofascial flap was utilized to repair the defects of larynx and reconstruct the glottis. For the cases of unilateral fixation of arytenoid, the arytenoids were removed and replaced by a piece of omohyoideus linked to hyoid bone, then were covered with mucous. The cases above T 2 supraglottic and T 3 glottic received radiotherapy.Result:The following-up time is 1～5 years.One case of supraglottic cancer(T 3)dies from local recurrence after operation for 2 years and 9 months.One case of glottic cancer(T 3)dies from neck and bone metastasis after operation for 4 years and 3 months.Swallow function was preserved in all cases.The rate of deconnalation was 95.8%. 91.7% patients had laryngeal functions restored. Conclusion:For selected cases, using omohyoid myofascial flap to repair the partial laryngeal defect and reconstruct glottis is available and practicable.

关 键 词：外科皮瓣 喉部分切除术 喉功能重建术 

分 类 号：R739.65[医药卫生—肿瘤]