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目的:利用缓降解骨基质明胶(BMG)修复喉框架缺损,以达到恢复喉的外形和功能的目的。方法:9例喉癌患者中,行部分喉切除或全喉切除术后,应用缓降解BMG植入喉框架缺损区或胸骨舌骨肌内,构建新的甲状软骨及喉的外形;同时应用缓降解BMG植入环杓肌及周围带神经末梢纤维黏膜下,包埋缝合,构建新的杓状软骨及杓间区,以恢复吞咽功能,防止误咽。结果:应用缓降解BMG重建新喉9例,其中部分喉切除5例,全喉切除2例,下咽及部分喉切除2例。随访1～5年效果满意,其中8例恢复了喉的外形和功能,1例患者需长期戴管、堵管发声。结论:应用缓降解BMG修复喉缺损,重建喉功能,既可恢复喉的外形,又可恢复喉的功能,是目前最为理想的新喉再造的生物活性材料和手术选择。
OBJECTIVE: To repair the laryngeal defects by using desquamative bone matrix gelatin (BMG) in order to restore the appearance and function of the larynx. Methods: Nine patients with laryngeal carcinoma underwent partial laryngectomy or total laryngectomy. The slow degeneration BMG was implanted into the laryngeal defect or sternohyoid muscle to construct a new shape of thyroid cartilage and larynx. At the same time, Degradation of BMG implanted in the circumferior and muscle fibers around the nerve endings mucosa, embedded suture, the construction of a new arytenoid cartilage and intertuberal area to restore swallowing function to prevent swallowing. Results: 9 cases of new throat were reconstructed by slow degradation BMG. Among them, 5 were partial laryngectomy, 2 were total laryngectomy, 2 were hypopharyngeal and partial laryngectomy. Follow-up 1 to 5 years with satisfactory results, of which 8 cases of laryngeal shape and function restored, 1 patients need to wear long tube, blocking the tube sound. CONCLUSION: It is the most ideal bioactive material and surgical choice for reconstructive laryngectomy that repairing laryngeal defects and reconstructing laryngeal function with slow degrading BMG can restore the appearance of larynx and restore laryngeal function.