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32例采用改良气管食管壁组织瓣法,施行全喉切除后发音重建术。发音效果:术后3周、1年、3年段5年的总有效率分别为87.5％、86.7％、84.2％及72.7％。重建失败4例,原因为气管食管痿口过大,活瓣倒翻入气管腔致误吸而封闭3例,因咽瘘诱发闭锁1例。术后发音变差4例,原因:气食管瘘口缩小2例、活瓣疤痕化1例及气室变形1例。认为改良后术式是有临床应用价值的发音重建术。
32 cases of modified tracheal esophageal wall flap method, the implementation of total laryngectomy after phonogenic reconstruction. Pronunciation effect: The total effective rates at 3 weeks, 1 year and 3 years after operation were 87.5%, 86.7%, 84.2% and 72.7% respectively. Reconstruction failed in 4 cases, due to tracheoesophageal atrophy mouth too large, the valve flap inverted into the trachea cavity caused by suction and closed in 3 cases, 1 case of atresia induced by pharyngeal fistula. 4 cases of postoperative poor pronunciation, reason: gas tube fistula narrowed in 2 cases, 1 case of valve scarring and gas chamber deformation in 1 case. That the modified operation is a valuable clinical value of phonological reconstruction.