摘要
目的 :探讨喉癌行全喉切除术后重建发声管的手术方法。方法 :为 32例行全喉切除术的患者重建发声管。结果 : 32例颈部切口 7～ 8d拆除缝线 ,1 0～ 1 3d拔除胃管 ,1 2～ 1 4d拔除发声管中的尿管 ,患者均可发声。 1～ 2 d后 2 6例出现不同程度的发声困难 ,经放疗后又逐渐能发声并不断改善 ,进流质饮食时有轻度呛咳 ,6例发声好 ,但进流质饮食时呛咳明显 ,前者发声管上口直径约 5mm,后者直径超过 6mm,呛咳与发声管上口直径大有关。结论 :全喉切除术后重建发声管需选择好适应证 ,用喉咽腔前壁粘膜形成倒梯形膜性管道 ,上口宜小 ,不仅发声好 ,而且不易呛咳。
Objective: To reconstruct the vocal tubal after complete laryngectomy Method:Thirty two cases with laryngeal carcinoma were treated complete laryngectomy and reconstructed vocal tubal.Results:The incisions were removed the stitches at 7～8 days,the gastric canal was extracted at 10～13 days,and the ureter was degrannulated at 12～14 days.All of them can vocalize.But after 1～2 days 26 cases had dysphonia and were improved after radiotherapy;6 cases had good phonation.The superior of the vocal tubal of the former is 5mm in diameter,of the latter is 6mm in diameter.The former had light choke,while the latter had more serious choke.Choking has something with the large diameter of the superior vocal tubal.Conclusion:Reconstruction the vocal tubal need good indication,and laryngopharyngeal anterior mucosa to form a inverted trapezoidal pipe with a small open.
关键词
喉肿瘤
喉切除术
发声
治疗
Laryngeal neoplasms
Laryngectomy
Phonation
