CAJ | 학술논문

目的晚期喉癌行全喉切除发音重建及防误咽一直是头颈肿瘤外科攻关难题 ,研究气-食管通路发声重建防治误咽的新方法 ,评价对叠式气-食管通路发声口重建及檐状会厌 "成形术防治误咽的疗效.方法将纵形切开的气-食管漏行衣襟样对叠缝合;保留带蒂环状软骨瓣并修成会厌形状;在重建气-食管通路发声口上方将会厌形状骨片植入食道前壁粘膜下,使曲面向下凸入食管腔形成檐状会厌".结果 33例喉鳞癌术后 3,7或 12 d 拔除鼻饲管,经 6～ 11 d常规进食适应后均无误咽.随访 2～ 5年, 28例无发声口漏, 2例癌复发肺、骨转移死亡, 3例失访.结论对叠式气-食管通路发声口及"檐状会厌"有效地防治误咽.
목적만기후암행전후절제발음중건급방오인일직시두경종류외과공관난제 ,연구기-식관통로발성중건방치오인적신방법 ,평개대첩식기-식관통로발성구중건급첨상회염 "성형술방치오인적료효.방법장종형절개적기-식관루행의금양대첩봉합;보류대체배상연골판병수성회염형상;재중건기-식관통로발성구상방장회염형상골편식입식도전벽점막하,사곡면향하철입식관강형성첨상회염".결과 33례후린암술후 3,7혹 12 d 발제비사관,경 6～ 11 d상규진식괄응후균무오인.수방 2～ 5년, 28례무발성구루, 2례암복발폐、골전이사망, 3례실방.결론대첩식기-식관통로발성구급"첨상회염"유효지방치오인.
Aim To estimate the curative effect of vocal reconstruction of tracheaesophageal passway and the brim shape epiglottis plasty.Methods A pedicel cricoid cartilage flap had been built as well as the epiglottis after total laryngectomy.A downward concave face of the brim shape epiglottis above the phonatory opening from the posterior wall of the trachea and the anterior wall of the esophagus was made.Results The nasal feeding tube was pulled out 3,7 or 12 days after operation of larynx squamous carcinoma and there was no any patient with accidental aspiration after routine eating for 6 to 11 days.Of 33 cases undergoing this operation, 27 patients had not happened food aspiration, 2 cases died due to recurrence of the carcinoma, 3 cases failed to follow up.Conclusion We consider this method not only can avoid aspiration of the food but also is advantageous to the function of speech and swallowing in different degree.