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目的 :探讨全喉切除防止气管 食管通路发声口误咽的方法。方法 :对 2 6例喉鳞癌患者行全喉切除 ,保留带蒂环状软骨瓣并修成会厌形薄片 ;改良气管 食管通路发声口 ;将会厌形骨片固定在发声口上方形成“檐状会厌” ;缝合气管断端并向后挤压“檐状会厌”凸入食管腔中。结果 :2 6例在术后 3、7或 12d拔除鼻饲管 ,经6～ 11d常规进食适应后均无误咽。随访 2～ 5年 ,2 1例无误咽 ,3例失访 ,2例癌复发。结论 :环状软骨瓣重建“檐状会厌”能有效防止全喉切除术后气管 食管通路发声口的误咽。
Objective: To explore the method of total laryngectomy to prevent vomiting of tracheal esophageal mucosal access port. Methods: Twenty-six patients with laryngeal squamous cell carcinoma underwent total laryngectomy, with the pedicled pedicled annular cartilage flap retained and the epiglottis lamellae preserved. The tracheal esophageal access vocalization was modified. The epiglottis-shaped bone fragment was fixed above the vocal outlet to form “eaves epiglottis” Stitched end of the trachea and back squeeze “eaves epiglottosis” convex into the esophageal cavity. Results: Twenty-six patients had nasal feeding tube removed at 3, 7 or 12 days after operation. During the follow-up of 2 to 5 years, 21 cases were free from swallowing, 3 cases were lost to follow-up and 2 cases had recurrence of cancer. Conclusion: The eyelid epiglottis reconstruction of annular cartilage flap can effectively prevent the pharyngeal tracheal esophageal mucosal vocal cessation after total laryngectomy.