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喉癌的治疗有二个重要问题,一是提高治愈率;一是术后恢复发音与讲话能力。前者已另文论述。现对术后恢复发音与讲话能力进行探讨。(一)临床资料 1977年12月起,共完成喉癌病人全喉切除加喉重建术7例。全部经证实为鳞状细胞癌。年龄最大62岁,最小45岁。男6例,女1例。病变部位:真假声带、喉室、前联合4例;喉前庭会厌喉面根部稍下方1例;假声带与会厌披裂皱襞之间2例。病变范围局限于喉部,侵犯肌层,但软骨未浸润,颈淋巴结未触及,其中1例合并有肺气肿,慢性支气管炎。(二)适应症与禁忌症适应症:喉内癌(包括声门区、声门上和声门下区癌,会厌喉面癌)。禁忌症:颈淋巴结转移已固定者:癌肿已侵犯颈部皮肤;食管受侵犯者。(三)治疗方法 (1)本组全部用针麻,个别加普鲁卡因局部浸润。(2)“T”型切口。(3)上在舌
The treatment of laryngeal cancer has two important problems. One is to improve the cure rate; the other is to restore the pronunciation and speech ability after surgery. The former has been discussed in another article. The postoperative recovery of pronunciation and speech ability are discussed. (A) Clinical data From December 1977, a total of 7 patients with laryngeal cancer underwent total laryngectomy and laryngeal reconstruction. All were confirmed as squamous cell carcinoma. The oldest is 62 years old and the youngest is 45 years old. There were 6 males and 1 females. Lesions: true and false vocal cords, larynx, anterior joint in 4 cases; laryngeal vestibular epiglottic laryngeal root slightly below 1 case; false vocal cords and epiglottis between the two cases. The lesions were confined to the larynx and invaded the muscular layer, but the cartilage did not infiltrate, and the cervical lymph nodes were not touched. One case involved emphysema and chronic bronchitis. (B) indications and contraindications indications: laryngeal cancer (including glottic, supraglottic and subglottic cancer, epiglottis cancer). Contraindications: Fixed cervical lymph node metastases: cancer has violated the neck skin; esophageal violations. (c) Treatment (1) All of the patients in this group used acupuncture and local infiltration of individual guprocaine. (2) “T” type incision. (3) on the tongue