目的　探讨环状软骨上喉次全切除术的可行性及其适应证。方法　选择自 1988～ 1996年不宜行常规水平或垂直半喉部分切除术的T2 和T3 喉鳞癌患者 2 1例行环状软骨上喉次全切除术。声门上型 9例 ,声门型 10例 ,跨声门型 2例。临床分级 :T2 期 16例 ,T3 期 5例。手术切除范围 :舌骨、甲状软骨板、会厌前间隙和声门旁间隙 ,保留环状软骨和至少一侧杓状软骨或部分正常会厌软骨。喉功能重建主要采用环状软骨舌根 (会厌舌根 )吻合术。结果　 95 %的患者恢复了正常的呼吸和吞咽功能 ,90 %的患者拔除气管套管获得正常的发音功能。 2例分别因顽固的吸入性肺炎和重建声门区狭窄需终生戴管。术后随访全部患者均无原位复发 ,17例存活 3年以上 ,13例已无瘤生存 5年以上。结论　作为喉近全切除术的一种类型 ,该术式能确切地描述手术的操作过程和喉腔重建的模式。正确选择手术适应证有助于提高中晚期喉癌患者无瘤生存时间和生活质量 Objective To investigate the feasibility and indications of subtotal cystectomy of annular cartilage. Methods Twenty-one patients with T2 and T3 laryngeal squamous cell carcinoma who were unsuitable for routine horizontal or vertical partial laryngectomy from 1988 to 1996 were selected for subtotal cystectomy. 9 cases of supraglottic, 10 cases of glottis, 2 cases of transglottic. Clinical grade: T2 in 16 cases, T3 in 5 cases. Surgical resection range: hyoid bone, thyroid cartilage, epiglottic space and supraglottic space, retaining the annular cartilage and at least one side of the arytenoid cartilage or part of the normal epiglottis cartilage. Laryngeal reconstructive use of the main ring cartilage tongue (epiglottis tongue) anastomosis. Results 95% of the patients returned to normal respiratory and swallowing functions, and 90% of the patients had their tracheal cannula removed for normal phonation. 2 cases were due to stubborn aspiration pneumonia and reconstruction of the glottis area need to be life-long wear tube. All patients were followed up for no recurrence in situ, 17 cases survived for more than 3 years and 13 had survived for more than 5 years without any tumor. Conclusions As a type of near-total laryngectomy, the procedure can accurately describe the operation procedure and model of laryngeal reconstruction. Correct choice of surgical indications will help improve the survival of patients with advanced laryngeal cancer-free survival and quality of life