目的 :探讨下咽、颈段食管癌根治术患者喉功能保留与发声重建的手术方法。方法 :对 16例下咽、颈段食管癌患者手术切除肿瘤后 ,实施保留全喉及部分喉切除喉功能重建 ;全喉切除后行Blom Singer 1期、2期发声重建术 ,同时下咽及颈段食管缺损分别采用胃 咽吻合、前臂游离皮瓣、胸大肌肌皮瓣、胸三角皮瓣、胸锁乳突肌肌皮瓣、颈前肌皮瓣、喉气管粘膜瓣等方法进行整复。保留全喉 8例 ,保留部分喉喉重建 3例 ,全喉切除后行Blom Singer发声重建 1期 4例 ,2期 1例。 结果 :16例中除 1例术后 14d心脏病突发死亡外 ,均恢复了吞咽功能 ,13例恢复发声功能 ,6例恢复了全喉功能 ,2例恢复了部分喉功能 (不能拔管 )。 5例行Blom Singer发声重建者 ,均发声成功。结论 :依据患者病变部位、肿瘤分期、身体状况、年龄等因素 ,切除肿瘤后采用不同的手术方法行喉功能保留及发声重建 ,可提高患者术后生存质量 Objective: To investigate the surgical methods of preserving laryngeal function and vocal reconstruction in patients with hypopharyngeal and cervical esophageal cancer radical mastectomy. Methods: Sixteen patients with hypopharyngeal and cervical esophageal cancer underwent surgical resection of the tumor. One hundred and thirteen patients with full-throat and partial laryngectomy were enrolled in this study. Blom Singer phase I and phase II vocal reconstruction were performed after total laryngectomy. The cervical esophageal defects were treated by anastomosis of stomach and pharynx, free flap of forearm, pectoralis major myocutaneous flap, thoracic triangle flap, sternocleidomastoid myocutaneous flap, anterior cervical myocutaneous flap, laryngotracheal mucosa flap and so on complex. Retained total larynx in 8 cases, retained part of the throat reconstruction in 3 cases, total laryngectomy line Blom Singer reconstruction in 1 case 4 cases, 2 cases in 1 case. Results: In all 16 cases, swallowing function was recovered except for sudden death of heart disease on the 14th day after operation. Thirteen patients recovered vocal function, 6 patients recovered full laryngeal function and 2 patients recovered partial laryngeal function (can not extubate) . 5 cases Blom Singer vocal reconstruction, both vocal success. Conclusion: According to the location of the lesion, tumor stage, physical condition, age and other factors, different surgical methods of laryngeal function retention and vocal reconstruction after resection of the tumor can improve postoperative quality of life