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1970年起,Staffieri开展了喉全切除后发声重建的新声门手术,迄今已达100余例,成功率约90％。作者在Staffieri方法的基础上略予改进,作了18例喉全切除后新声门重建术,患者均为T~3或T~4喉内癌或梨状窝癌。手术方法和常规喉全切除术不同的是:沿两侧杓会厌皱襞下方作切口,保留梨状窝粘膜及环后区粘膜肌肉,作成肌粘膜瓣。在第四第五气管环作气管造口术。接着,横断第一气管环,将气管由前向后剪修成斜面,把上述环后肌粘膜瓣覆盖于气管顶部,使术者可将新声门位置标出:它距气管内唇后0.5cm,新声门本身应长0.5cm。在手指伸入食管上端衬托下,切开咽前壁肌层及
Since 1970, Staffieri has launched a new glottic surgery for vocal reconstruction after total laryngectomy. So far, it has reached more than 100 cases with a success rate of about 90%. The authors made some improvements on the basis of the Staffieri method. Eighteen patients underwent total glocal reconstruction after total laryngectomy. All patients were T ~ 3 or T ~ 4 laryngeal carcinoma or pyriform sinus cancer. Surgical methods and conventional laryngectomy different is: along both sides of the crape mytilus follicles under the incision for the preservation of the pear-shaped fossa mucosa and posterior zone mucosal muscle, made of muscular flap. The fourth fifth tracheal ring was used for tracheostomy. Next, the first tracheal ring is traversed, the trachea is trimmed anteriorly and posteriorly, and the posterior posterior muscularis mucosal flap is placed over the top of the trachea to allow the surgeon to mark the new glottis position: 0.5 cm , The new glottal door itself should be long 0.5cm. Under the finger into the upper esophageal wall, cut off the anterior pharyngeal muscle layer and