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大剂量放疗(>6500rad)是早期喉癌常用的治疗方法,而那些放疗失败者的处理却是一难题,因其影响创口愈合,瘘管发生率可高达30～73％,需多次清创并分期手术才能治愈,住院时间明显地延长。 Schweitzer(1962)、Chandler(1979)和Harrison(1980)先后提出了以咽造口术使唾液改道流出,防止组织坏死,取得了良好效果。本文作者采用在全喉切除后行“T”字形缝合关闭咽口时,将“T”字形的垂直部缝合至其水平下方1cm处及水平部两侧各缝合1～2cm,留下一菱形缺口,再在围裙式皮瓣基部中央作2cm的垂直切口,将喉咽部粘膜拉出与皮肤间断缝合以完成咽造口术。术后第一天即可发挥作
High-dose radiation therapy (>6500 rad) is a commonly used treatment method for early laryngeal cancer, and the treatment of those who fail to treat radiation is a difficult problem, because it affects wound healing, the incidence of fistula can be as high as 30 to 73%, requiring multiple debridement and Surgery can be cured by stages, and hospital stays are significantly longer. Schweitzer (1962), Chandler (1979), and Harrison (1980) proposed the use of pharyngostomy to divert salivary flow and prevent tissue necrosis, achieving good results. The authors used a “T”-shaped suture to close the pharyngeal orifice after total laryngectomy. The “T”-shaped vertical part was sutured to 1 cm below its level and 1 to 2 cm to both sides of the horizontal part, leaving a diamond-shaped gap. Then, a 2 cm vertical incision was made at the base of the apron flap base, and the pharyngeal mucosa was pulled out and interrupted with the skin to complete the pharyngostomy. Can be played on the first postoperative day