摘要
目的 对于喉部病变 ,在得到有效治疗的同时 ,最大限度地保留正常和高质量的发声功能。方法 1986～ 2 0 0 0年中日友好医院耳鼻咽喉科应用嗓音显微外科技术治疗 115 3例喉部疾病。根据喉部各种良性病变 (声带小结、声带息肉、Reinke水肿、声带囊肿等 )和不同阶段早期恶性病变及声带癌前病变侵犯的组织学深度 ,分别采用显微切除技术、外侧微瓣技术、内侧微瓣技术、黏膜下注射技术、黏膜剥脱及激光切除术等 ,切除病变组织 ,最小伤及正常组织和对发音质量的影响。结果10 4 4例 (99 8% )声带小结、声带息肉、声带囊肿和 12例Reinke水肿在通过显微切除技术、外侧微瓣技术、内侧微瓣技术等治疗后均能在 1周后获得正常发音 ,2例巨大声带息肉患者半年内声嘶改善不满意 ;2 0例Reinke水肿、31例癌前病变经黏膜剥脱及黏膜表皮剥脱处理 ,除 3例癌前病变术后复发又经 2、3次手术 ,其余均在 1～ 3个月内恢复正常发音。 34例声带癌经黏膜剥脱处理 ,5例声带癌和 5例喉乳头状瘤经激光切除 ,术后 5年以上随访 5例声带癌复发 ,其中 2例再次行黏膜剥脱术 ,1例乳头状瘤反复 4、5次手术。治疗后的发音效果均比经颈部切除手术好。
Objective To find a way of reserving normal high quality phonatory function after vocal cord surgery Methods Various benign lesions (vocal nodules,polyp of vocal cord,cyst of vocal cord, etc) as well as premalignant lesion and early glottic cancer were treated with minimally excision,lateral microflap,medial microflap,submucosal infusion,mucosal stripping or epithelium stripping of phonomicrosurgical techniques to achieve minimally invasion Results The 1 044 (99 8%)patients suffering from vocal nodules, polyp or cyst and 12 Reinke′s edema achieved a normal phonation within a week The recovery of normal phonation in 20 Reinke′s edema, 31 vocal cases needed 1 3 months,by mucosal stripping The restoration of phonation on 5 papilloma,36 early malignancy were better than trans cervical operation After 5 year follow up,3 cases of vocal cord premalignant lesions received the re stripping operation 32 cases of early glottic cancer remained tumor free,5 cases relapsed and 2 cases received the re stripping operation, and 2 cases received laryngectomy operation Conclusion The phonomicrosurgery may cure vocal disease and reserves good vorce function
出处
《中华耳鼻咽喉科杂志》
CSCD
北大核心
2002年第4期296-299,T006,共5页
Chinese Journal of Otorhinolaryngology
