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全喉切除术后关闭咽缺损时常将粘膜及粘膜下分层缝合,且缝线穿过咽缩肌使其关闭,以增加咽壁的强度。但由于采用气管食管造孔发音法,使一些患者在充气发音时出现明显的咽肌痉挛而不能讲话。为了克服这一问题,属者对20例喉癌患者在正规的喉切除后只缝合咽部粘膜及粘膜下层,而使咽肌完全开放,并与闭合咽缩肌的25例喉切除者对照。结果表明,在咽缩肌开放的20例中,5例气管食管造孔发音成功,2例术后发生小的咽瘘,经换药治疗自行愈合;在对照组中,9例气管食管造孔发音成功,1例需进行咽肌切开,8例术后发生
Close the pharyngeal defect after total laryngectomy often mucosa and submucosal stratified suture, and the suture through the pharyngeal constrictor to close, in order to increase the strength of the pharyngeal wall. However, due to the use of tracheal esophageal hole pronunciation method, so that some patients in the inflatable pronounced pharyngeal spasm and speech can not speak. In order to overcome this problem, the subjects of the laryngeal cancer patients in 20 cases of laryngectomy after the regular only sutured the pharyngeal mucosa and submucosa, leaving the pharyngeal muscle completely open, and with the closure of the throat of 25 cases of laryngectomy control. The results showed that in the 20 cases of pharyngeal constriction muscle open, 5 cases of tracheal esophagectomy success, 2 cases of small pharyngeal fistula occurred after surgery, self-healing by dressing change; in the control group, 9 cases of tracheoesophageal hole Successful pronunciation, 1 cases need pharyngeal muscle incision, 8 cases occurred after surgery