对83例全喉切除术后发音重建进行前瞻性研究。男79例,女4例;年龄36～80岁。肿瘤原发于喉咽部37例,喉腔33例,喉外13例。44例术后行放疗,16例放疗失败后行手术治疗,5例行食管喉切除,儿例行喉次全切除,2例术后死亡。各种发音重建方法根据病人具体情况而定。最初两年,气管食管造瘘术的适应症为65岁以下,要求发音,无动脉炎、糖尿病及放疗史,肿瘤位于喉内,但梨状窝肿瘤为禁忌。以后,气管食管造瘘术适应症逐渐扩大,到本研究结束时,大部分全喉切除行Ⅰ期气管食管造瘘术,几乎没有禁忌症,除非全身情况差,手指不灵活,才建议使用食管音。发音效果分类:S_0:失败,没有声音;S_1:音质差或不 83 cases of total laryngectomy phonetic reconstruction prospective study. 79 males and 4 females; aged 36 to 80 years. Tumor in 37 cases of hypopharyngeal, throat 33 cases, throat 13 cases. Forty - four patients underwent radiotherapy, 16 patients underwent radiotherapy after operation, 5 patients underwent esophageal laryngectomy, and 2 patients underwent total laryngectomy. Two patients died after operation. A variety of pronunciation reconstruction method according to the specific circumstances of the patient. The first two years, tracheoesophageal ostomy indications for patients under 65 years old, requiring pronunciation, no arteritis, diabetes and radiation therapy history, the tumor is located in the throat, but the pear-shaped tumor is taboo. Later, tracheal esophageal ostomy indications gradually expanded to the end of the study, most of the total laryngectomy line Ⅰ tracheal esophageal ostomy, almost no contraindications, unless the general condition is poor, the fingers are not flexible, it is recommended to use the esophagus sound. Sound effects classification: S_0: failed, no sound; S_1: poor sound quality or not