Selective myotomy for voice restoration after total laryngectomy.
Selective myotomy for voice restoration after total laryngectomy.
复制标题
全喉切除术后选择性肌切开术恢复声音。
DOI：
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发表时间：
1981
期刊：
影响因子：
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通讯作者：
E. Blom
中科院分区：
文献类型：
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作者：
M. Singer;E. Blom
全喉切除术后咽食管重建避免了唾液瘘的发生，并恢复了令人满意的吞咽。成功的闭合技术包括多层组织、选择的缝合材料、术后放射治疗的应用和改良的颈淋巴结清扫术。此外，传统上，发声康复与在空气吹入后能够产生声音的咽食管段的形成相关联。129例患者在接受全喉切除术和气管食管分流术后的三年经验显示，16例（12%）患者因咽食管痉挛而在气管食管穿刺后未能获得满意的语音。对14例患者进行经皮咽丛阻滞和随后的颈咽肌和咽缩肌切开术的反应进行了评估。全喉切除术后咽食管张力增加似乎是无法获得食管发音的重要因素。
Reconstruction of the pharyngoesophagus after total laryngectomy avoids the development of salivary fistulae and restores satisfactory swallowing. Successful techniques for closure include multiple layers of tissue, selected suture materials, the application of postoperative radiation therapy, and modified neck dissection. In addition, vocal rehabilitation has been traditionally associated with the formation of a pharyngoesophageal segment capable of producing sound after air insufflation. A three-year experience with 129 patients after they underwent a total laryngectomy and tracheoesophageal shunt showed that 16 patients (12%) failed to achieve satisfactory speech after tracheoesophageal puncture because of pharyngoesophageal spasm. Response to percutaneous block of the pharyngeal plexus and subsequent myotomy of the cricopharyngeus and pharyngeal constrictor muscles was assessed in 14 patients. Increased pharyngoesophageal tone after total laryngectomy seems to be an important factor in the failure to acquire esophageal voice.