摘要
为恢复全喉切除后患者的语言功能，同期成形盖瓣式发音管。方法：将气、食管之间向下分离５０ｍｍ，于气管后壁切取组织瓣长约２０ｍｍ，其上端宽约１０ｍｍ为蒂部，下端宽约８ｍｍ，侧端连５ｍｍ×６ｍｍ气管粘膜软骨断离，将此粘膜软骨外翻折叠缝成盖瓣。再于气管后壁切口相对应的食管前壁切取组织瓣长约２０ｍｍ，其上端宽约１５ｍｍ断离，下端宽约１０ｍｍ为蒂部，将两组织瓣上下交叉缝成发音管，缝合气管壁、食管壁剩余切口。发音管内放入１２号导尿管扩张１０天，将气管断端与颈前皮肤缝合造孔。１２例手术均获成功，患者术后饮食顺利无误咽，语言清晰连贯性好，并保持地方语音和性别语调特色，经语言及频谱监测，语言功能接近正常人。该术式对声门上型、声门型喉癌患者，在全喉切除后同期行发音功能重建是较理想的方法。
Inordertorestorethepatients′speechfunctionaftertotallaryngectomy,thespeechrestorationoperationhasbeendonesuccessfulyin12patientswithlaryngocarcinomasbymakingtegmentalvalvefistulafromesophagealflapandtrachealtissueaftertotallaryngectomy.First,thetracheaandtheesophaguswereseparated,andatissueflap20mminlengthfrompostrachealwalwasmade.Itsupperendwas10mminwidth,lowerend8mm,lateraly5mm×6mm,thetrachealmucosaandcartilageweresewnuptoformategmentalvalve,then,atissueflap20mminlengthfromthepreesophagealwalwasdonewithitsupperend15mminwidth,lowerend10mm.Thenategmentalvalvefistula(speech-tube)wasmadebysewinguptwoflapscrisscrossanda12Fcatheterwasinsertedintothetegmentalvalvefistulaasasupporterfor10days.Finaly,atracheostomywasperformedbysewingupthetracheatotheneckskin.Alpatientscouldspeakfluentlyandclearlyaf-tersurgeryandkepttheirsexanddialectcharacteristicswhereaswithoutmisswalowing.Theopera-tionisaperfectwayfortoatllaryngectomywithspeechrestorationinpatientswithupperglottalorglotallaryngocarcinomas.
出处
《中华耳鼻咽喉科杂志》
CSCD
1996年第4期203-205,共3页
Chinese Journal of Otorhinolaryngology
关键词
喉肿瘤
喉切除术
造口术
LaryngealneoplasmsLaryngectomyOstomySpeech,alaryngeal
