摘要
目的 探讨显微支撑喉镜下激光治疗早期声门癌及癌前病变的临床疗效。方法 经病理诊断并经术后病理证实的 ９例早期声门癌（Ｔ１Ｎ０Ｍ０）及 １７例癌前病变于全麻支撑喉镜显微镜下行三种类型激光声带切除或部分切除术。结果 经平均１２个月随访，２例喉角化症分别于术后３个月、５个月复发而重行激光手术，其余病例无复发征象，近期疗效满意。行激光Ⅰ型声带术者，术后１月创面新粘膜修复覆盖，约２－３月后发声功能基本恢复正常。Ⅱ－Ⅲ型者，术后２月创面新粘膜修复覆盖，术后６月术区有声带样粘膜隆起代替，发声功能明显优于既往传统术式，无并发症出现。结论 对早期声门癌及癌前病变应用支撑喉镜显微镜下激光声带手术是行之有效的微创伤性手术，既达到了根治肿瘤的目的，又明显提高了术后发声质量。
Objective The purpose of the present work is to investigate the clinical micro-effectiveness of microendoscopic and laser surgery for managing early glottic carcinoma and laryngeal precancerous lesions. Methods Nine patients with stage I glottic carcinoma(T1N0M0) and seventeen patients with laryngeal precancerous lesions were operated under microendoscope and with CO2 laser. All cases were diagnosed pathologically, and the preformed operations could he differentiated to three patterns, namely Type Ⅰ ,Ⅱ and Ⅲ. Results Data of follow-up for average 12 months showed that excellent local control was achieved in all cases with the exception of two cases of laryngeal keratosis. These two recurred 3 and 5 months after operation respectively and treated with laser surgery again. It was at least indicated that short-term effect of the treatment was satisfying. The vocal cord defect caused by laser ablation recovered by new growing mucosa 1 month after Type I surgery, and the voice function recovered in 2 .-3 months. However, after Type Ⅱ and Ⅲ surgery, the new mucosa appeared in 2 months, and the caved area was filled and replaced with proliferating tissue 6 months later. Thus the endoscopic laser surgery provided better functional results than conventional surgery, and without any complications. Conclusion It is effective and micro-traumatic to treat early glottic carcinoma and laryngeal precancerous lesions with microendoscopic and laser surgery. By such an operation we could not only ablate the cancer radically, but also improve the postoperative voice quality.
出处
《听力学及言语疾病杂志》
CAS
CSCD
2002年第1期21-23,共3页
Journal of Audiology and Speech Pathology
