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本文介绍了将病变清除与肺驱动的嗓音重建相结合,以保存嗓音的次全喉切除术。术前强调行喉镜检查,认真评估声带活动性与病变的准确范围。术中利用尚可保留的一侧杓状软骨及其毗邻结构,缝制成具有括约功能的声瘘管,上通下咽腔,下接气管。已为31例喉癌T3患者施行这种手术,术后不用带管,吃喝不呛;手指堵住气管造口就能连续大声说话,音质自然,咬字清楚。表明本术式克服了现行的全喉与半喉切除术顾此失彼的缺点,能为大多数喉癌T_3患者保存满意的嗓音。
This article describes subtotal laryngectomy that combines lesion clearance and pulmonary-driven voice reconstruction to preserve the voice. Preoperative emphasis on laryngoscopy, a careful assessment of the exact range of vocal cord activity and lesions. Intraoperative use can still be retained on the side of the arytenoid cartilage and its adjacent structure, sewn into a sonicated fistula tube, through the lower pharyngeal cavity, the next access to the trachea. 31 cases of laryngeal cancer has been performed in patients with T3 surgery, postoperative do not take the tube, eat and drink not choke; finger blocked tracheostomy will be able to speak continuously, the sound quality of natural, articulate clear. This procedure overcomes the shortcomings of the current total laryngectomy and semidhlaryctomy, which can save the satisfactory voice for most laryngeal cancer T_3 patients.