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目的 :探讨垂直喉部分切除术后改善发声、恢复喉功能的修复手段 ,以提高喉癌患者术后的生存质量。方法 :垂直喉部分切除术后 ,用患侧甲状软骨外膜修复上半喉腔缺损 ,取健侧胸舌骨肌瓣 (或舌骨 胸舌骨肌瓣 )修复下半喉腔缺损并重建声带。结果 :修复的新喉腔呈三角形 ,重建的声带具有一定的张力并参与发声 ,恰似一侧居于正中位麻痹的声带 ,发声时由健侧声带代偿运动与新声带前 2 /3相互靠近。 93 .4%的患者发声近乎正常或自觉发声质量较术前明显好转。结论 :垂直喉部分切除术后采用患侧甲状软骨外膜和健侧胸舌骨肌瓣 (或舌骨 胸舌骨肌瓣 )修复缺损并重建声带 ,方法简单 ,取材方便 ,创伤小 ,效果满意 ,可作为垂直喉部分切除术后声带重建的首选方法
Objective: To discuss the methods of improving the vocalization and resuming laryngeal function after vertical partial laryngectomy to improve the quality of life of laryngeal cancer patients. Methods: After the vertical partial laryngectomy, the upper half throat defect was repaired with the ipsilateral thyroid cartilage and the lower semithoracic cavity defect was reconstructed with the contralateral chest thoracic muscle flap (or the hyoid cheekbone flap) . Results: The repaired new throat had a triangular shape. The reconstructed vocal cords had some tension and participated in vocalization, just like the vocal cords in the median paralysis on one side. When the vocal cord was compensated, the contralateral vocal fold compensated with the former 2/3 of the vocal cords close to each other. 93.4% of patients with almost normal voice or consciously sound quality was significantly improved compared with preoperative. Conclusion: After the vertical partial laryngectomy, the ipsilateral thyroid cartilage adventitia and the contralateral thoraco-hyoid muscle flap (or the hyoid cheekbone flap) are used to repair the defect and reconstruct the vocal cord. The method is simple, easy to draw, less traumatic and satisfactory , Can be used as the preferred method of vocal cord reconstruction after vertical laryngectomy