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本文将因喉癌喉切除术后应用人工发音钮发声重建术78例的临床资料进行分析,其中一期安放66例,发音成功率95.7%;二期手术12例,发音成功率50.0%。手术气管造瘘直径大于20mm,按放发音钮采用横切口,且与发音钮的通气管直径大小相同,可减少并发症,提高发音成功率。不发音者其原因考虑为:①环咽肌和咽缩肌痉挛;②术中下咽粘膜和食管粘膜切除过多,术后咽腔和食管狭窄;③高龄和体弱患者。本手术方法简便易行,几乎所有喉全切除患者均可采用此技术,发音亦可保持原有的方言特点。
This article will be laryngectomy after the application of artificial voice button reconstruction of the clinical data of 78 cases were analyzed, of which 66 cases were placed in a period, the success rate of 95.7%; second surgery in 12 cases, the success rate of 50 pronunciation. 0%. Operative tracheostomy diameter greater than 20mm, press the release button with transverse incision, and with the sound button the same size of the ventilation tube, can reduce complications and improve the success rate of pronunciation. The reason is not pronounced as: ① cricopharyngeal muscle and pharyngosygdridsis spasm; ② intraoperative pharyngeal mucosa and esophageal mucosa resection too much, postoperative pharynx and esophageal stenosis; ③ elderly and frail patients. The method is simple and easy to operate. Almost all patients undergoing total laryngectomy can adopt this technique, and the pronunciation can maintain the original dialect features.