摘要
目的:分析环状软骨上喉部分切除-环舌根会厌吻合术有效重建新喉吞咽功能的机制。方法:选择1995-2005年间行环状软骨上喉部分切除-环舌根会厌吻合手术的患者40例,对术后吞咽等功能经时调查,随机选择12例术后6个月的患者进行CT正中矢状位扫描,测量会厌与环状软骨间夹角、新声门高度、舌根与新声门的位置关系,探讨新喉结构对吞咽功能的影响。结果:术后拔除胃管恢复正常饮食所需时间:10d内20例,20d内18例,30d内2例,新声门位于颈前第4颈椎下缘高度,会厌与环状软骨间夹角为(62±6.5)°,舌根、会厌和环状软骨连接较近没有分离。结论:应用环舌根会厌吻合术重建的新喉吞咽功能恢复良好,舌根-会厌-环状软骨紧密结合是有效防止误咽的关键。
Objective： To analyze the mechanism of the functional reconstruction of swallowing after supracricoid partial laryngectomy with anastomosis of cficoid cartilage,base of tongue,and epiglottis,the modified surgical technique of supmcricoid partial laryngectomy with cricohyoidoepiglottopexy （SCPL-CHEP）. Melhods：The swallowing function of 40 patients undergoing SCPL-CTEP from 1995 to 2005 was investigated. Anteroposterior CT scans were performed in 12 patients 6 months after the operation to investigate the included angle between the epiglottis and erieoid cartilage,the level of the neoglottis,and the positional relationship between the base of tongue and neoglottis. The effect of the neoglottis on swallowing function was analyzed. Results：The times the patients need to return to normal diet were within 10 days in 20 patients, within 20 days in 18 patients, and within 30 days in 2 patients. The neoglottis was under the level of the 4th cervical vertebra. The included angle between the epiglottis and the erieoid was 62°±6.5°. The base of tongue,epiglottis,and efieoid cartilage were conjugated tightly. Conclusion： The swallowing function recovers well after the operation. The tightly conjugation of erieoid cartilage,base of tongue,and epiglottis is the key factor in preventing aspiration.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2007年第1期69-70,75,共3页
Journal of China Medical University
基金
教育部回国留学人员科研启动基金资助项目(2006331)
关键词
喉肿瘤
环状软骨上喉部分切除
环舌根会厌吻合术
并发症
laryngeal tumor
supmcficoid partial laryngectomy with efieohyoidoepiglottopexy
complication
