Neoglottal revisions after supracricoid laryngectomy with cricohyoidoepiglottopexy
Neoglottal revisions after supracricoid laryngectomy with cricohyoidoepiglottopexy
复制标题
环舌骨会厌固定术环上喉切除术后新声门修正
DOI：
10.1093/jjco/hyw044
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发表时间：
2016
影响因子：
2.4
通讯作者：
加納孝一
中科院分区：
文献类型：
--
作者：
中山明仁;宮本俊輔;清野由輩;岡本旅人;加納孝一
环状软骨上喉切除环舌骨会厌固定术是一种保留喉功能的手术，适用于T2和精选的T3-T4声门型喉癌。为了获得最佳的功能结果，必须使用适当的手术技术。尽管采用熟练的技术进行手术，但可能会遇到各种术后并发症。在这项研究中，我们分析了后环状软骨上喉切除术与环舌骨会厌固定术的患者谁收到二次手术修订，因为neoglotalissues.MethodsWe分析了喉癌（鳞状细胞癌）谁收到环状软骨上喉切除术与环舌骨会厌固定术在1997年和2015年之间在我们的研究所的患者。我们回顾性分析了临床特点，危险因素和二次revisionscarried. ResultsAbout 20%的119后环上喉切除术与环舌骨会厌固定术患者需要二次修订，以实现良好的neoglottis。在24例患者中，14例（58%）表现为由于杓状软骨和/或肉芽的多余粘膜引起的新声门狭窄，并进行了内镜切除术。4例患者显示新声门扩大，并进行颊脂填充。4例患者表现为会厌内翻，并通过内窥镜途径进行会厌切除术治疗。两名患者表现出环状软骨炎，由于颈部骨刺刺激，他们通过开放的方法进行骨刺切除治疗。二次翻修后，气管造口成功关闭，在所有24 patients.ConclusionsHead和颈部外科医生应该意识到的高风险后，环状软骨上喉切除术与环舌骨会厌固定术的新声门并发症，所以需要做好二次翻修的准备。通过及时发现并采取适当的翻修术，可以纠正新声门并发症，恢复喉功能。
ObjectiveSupracricoid laryngectomy with cricohyoidoepiglottopexy is a functional larynx-preserving surgery designed for T2 and well-selected T3–T4 glottic type laryngeal cancers. To obtain optimal functional results, proper surgical techniques must be used. Regardless of operating with skilled techniques, various post-operative complications may be encountered. In this study, we analyzed post-supracricoid laryngectomy with cricohyoidoepiglottopexy patients who received secondary surgical revisions because of neoglottal problems.MethodsWe analyzed the patients with laryngeal cancers (squamous cell carcinoma) who received supracricoid laryngectomy with cricohyoidoepiglottopexy between 1997 and 2015 at our institute. We retrospectively reviewed the clinical features, risk factors and the secondary revisions carried out.ResultsApproximately 20% of the 119 post-supracricoid laryngectomy with cricohyoidoepiglottopexy patients required secondary revisions to achieve a favorable neoglottis. Among the 24 patients, 14 (58%) demonstrated neoglottal stricture due to the redundant mucosa of the arytenoid and/or granulation, and were operated on with endoscopic resection. Four patients showed enlargement of the neoglottis, and buccal fat augmentation was performed. Four patients showed an inverted epiglottis and were treated by epiglottectomy through an endoscopic approach. Two patients exhibited cricoid chondritis due to cervical spur irritation, and they were treated by spur resection through an open approach. After secondary revision, the tracheal stoma was successfully closed in all 24 patients.ConclusionsHead and neck surgeons should be aware of the high risk of neoglottal complications after supracricoid laryngectomy with cricohyoidoepiglottopexy, and so need to be well prepared for secondary revisions. By promptly detecting and adopting proper revisions, neoglottal complications can be corrected and laryngeal functions recovered.