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目的 :评估喉全切除环状软骨瓣“檐状会厌”成形术防治气 -食管通路发声口误咽的疗效。方法 :喉全切除后保留带蒂环状软骨瓣并修薄成会厌形状 ;在重建气 -食管通路发声口上方将会厌形状骨片植入食管前壁粘膜下 ,使曲面向下凸入食管腔形成“檐状会厌”。结果 :2 6例喉鳞癌术后 3、7或 12天拔除鼻饲管 ,经 6～ 11天常规进食适应后均无误咽。随访 2～ 5年 ,2 1例无发声口漏 ,2例术后 5、11个月癌复发肺、骨转移死亡 ,3例失访。结论 :环状软骨瓣“檐状会厌”成形术有效防治全喉切除术后气 -食管通路发声口的误咽。
Objective: To evaluate the efficacy of pharyngeal resection of annular cartilage flap “eyelid epiglottis” in the prevention and treatment of gas-esophageal vocal invagination. Methods: The pedicles of pedicled pedicled annular cartilage flap were retained and slender into the epiglottis shape after total laryngectomy. The epiglottis shaped bone fragments were implanted into the anterior esophageal mucosa above the sounding port of the reconstructed gas-esophageal access, and the curved surface was convex downward into the esophageal cavity “Eaves epiglottis.” Results: Twenty-six cases of laryngeal squamous cell carcinoma were removed on 3, 7 or 12 days after operation. After 6 to 11 days of routine feeding, no swallow was found. During 2 to 5 years of follow-up, 21 patients had no acoustic leakage and 2 patients had lung cancer recurrence 5 and 11 months after operation. Bone metastasis and death were observed in 3 patients. CONCLUSION: The annular eyelid epiglottis flap is effective in preventing and treating pharyngeal aspiration of the gas-esophageal access sound port after total laryngectomy.