摘要
目的 :探讨Ⅰ、Ⅱ期喉癌手术拔管后再发喉狭窄的原因及处理方法。方法 :对 17例喉狭窄者根据病因采用不同的手术方法。经纤维喉镜导入激光治疗喉狭窄 2例 ,支撑喉镜下喉腔内肉芽组织切除术 2例 ,喉裂开会厌喉成形术 6例 ,瘢痕及残留甲状软骨板切除、接力肌甲状软骨膜瓣或颈阔肌皮瓣修复术 4例 ,全喉切除术 3例。结果 :除 3例复发喉癌患者行全喉切除外 ,其余 14例患者经再次手术后有 13例重新恢复呼吸、发声及吞咽功能 ,拔管率为 92 .86 %。结论 :瘢痕及肉芽组织增生是导致Ⅰ、Ⅱ期喉癌手术拔管后再发喉狭窄的主要原因 ,根据不同病因采用不同的手术方法 。
Objective:To investigate the causes and management of laryngostenosis in clinical stage Ⅰ,Ⅱ laryngeal cancer patients after decannulation. Method:The causes of seventeen cases laryngostenosis after decannulation were analyzed and various operations were carried out according to the causes. Two cases were treated by laser through fibrolarngoscope,granulation tissue in laryngeal cavity were resected by selfretcuining laryngoscope in two patients. The laryngeal cavity scar was removed and the epiglotic flap,bi pedicled myoperichondral flap,platysma myocutaneous flap were utilized to reconstruct the laryngeal functions in ten patients. Three patients were treated by total laryngectomy. Result:Except for three cases of total laryngectomy,thirteen cases were decannulated successfully after the second operation,decannulation rate was 92.86 %. Conclusion:The scar hyperplasia and granulation tissue are the major causes of secondary laryngostenosis after decannulation in clinical stage Ⅰ,Ⅱ laryngeal cancer patients. Most of them regained own respiration,swallow and voice function.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2004年第6期341-342,共2页
Journal of Clinical Otorhinolaryngology
关键词
喉肿瘤
喉部分切除术
喉狭窄
Laryngeal neoplasms
Laryngectomy
Laryngostenosis
