胸骨舌骨肌筋膜瓣舌根成形术治疗晚期喉声门上型癌

目的探讨晚期喉声门上型癌治疗中减少误咽的手术方法。方法对19例晚期喉声门上型癌进行手术治疗,采用胸骨舌骨肌筋膜瓣修复延长舌根,再将残喉与新舌根吻合重建喉功能。术后辅以放射治疗。结果19例中15例拔管,拔管率为78.9%,患者均恢复了较好的经口进食功能,无误咽病例出现,发音功能良好。3年生存率为84.2%(16/19),5年生存率为57.1%(8/14)。结论胸骨舌骨肌筋膜瓣舌根成形术操作简单,能恢复满意的喉、舌功能,可有效减轻或避免术后误咽的发生,是晚期喉声门上型癌手术治疗中理想的手术方法。

Reconstruction of tongue base by sternohyoid myofascial flap in surgical treatment of advanced supraglottic carcinoma

OBJECTIVE To study the method ofavoiding the postoperative aspiration in surgical treat-ment of advanced supraglottic carcinoma invaded thetongue base. METHODS Nineteen cases of advancedsupragolttic carcinoma were treated surgically, the tu-mor were completely removed and the tongue base wererebuilt by sternohyoid myofascial flap. All the casesreceived postoperative radiotherapy. RESULTS Out ofthe 19 cases, 15 cases were decannulated with adecannulation rate of 78.9 %. All the cases resumednormal diet and good speaking functions, none pre-sented complication of accidental aspiration. The 3- and5-year survival rates were 84.2 % and 57.1 %respectively. CONCLUSION Reconstruction of tonguebase by sternohyoid myofascial flap can resumed sat-isfied glossal and laryngeal functions, which is easilyand simply performed with less damage and postop-erative accidental aspiration, appropriate for surgicaltreatment of advanced supraglottic carcinoma.