Buccal fat augmentation for insufficient neoglottal closure after supracricoid laryngectomy with cricohyoidoepiglottopexy.
Buccal fat augmentation for insufficient neoglottal closure 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闭合不足的颊脂肪填充。
DOI：
10.1016/j.anl.2012.09.001
复制
发表时间：
2012
影响因子：
1.7
通讯作者：
M.
中科院分区：
文献类型：
--
作者：
Nakayama;M.;Watanabe;A.;Matsuki;T.;Tamura;E.;Seino;Y.;Okabe;S.;Okamoto;T.;Miyamoto;S.;Okamoto;M.
环状软骨上喉切除环舌骨肌会厌固定术（SCL-CHEP）是一种治疗喉癌的功能性器官保留手术。术后喉功能一般是有希望的。然而，有些患者由于新声门过宽导致新声门闭合不充分而不能获得满意的功能结果。自体颊脂填充术用于矫正不足。患者和方法两名患者接受了干预。在全身麻醉下，从颊脂垫上采集自体脂肪。在直接喉镜下将脂肪组织注射到新声门的最宽平面;结合导航系统以识别责任部位。通过沿着声学、空气动力学和知觉分析以及视频透视吞咽研究和筛选问卷进行功能评估。在责任部位的粘膜下间隙中注入了0.8ml（病例1）和0.7ml（病例2）的脂肪组织。这两个病人经历了主观的功能改善增强后，语音和吞咽的心理参数也improved.CONCLUSIONSBuccal脂肪增加，以纠正SCL-CHEP后新声门关闭不足，在技术上是可行的。导航系统有助于确认。发生脂肪吸收，在3个月和6个月时仍有三分之一的体积。虽然声音测量保持不变，但声音和吞咽的心理参数有所改善。
OBJECTIVESupracricoid laryngectomy with Cricohyoidoepiglottopexy (SCL-CHEP) is a functional organ preservation surgery for laryngeal cancers. Post-operative laryngeal function is generally promising. Some patients, however, cannot attain satisfactory functional results because of an excessively wide neoglottis resulting in an insufficient neoglottal closure. Autologous buccal fat augmentation was conducted to correct the insufficiency.PATIENTS AND METHODSTwo patients underwent intervention. Under general anesthesia, autologous fat was harvested from the buccal fat pad. Fat tissue was injected into the widest plane of the neoglottis under direct laryngoscopy; a navigation system was incorporated to identify the responsible site. Acoustic, aerodynamic, and perceptual analyses along with videofluoroscopic swallowing study and screening questionnaires were used for functional evaluation.RESULTSA total of 0.8ml (Case 1) and 0.7ml (Case 2) of fat tissues were injected into the submucosal space of the responsible sites. Both patients experienced functional improvement subjectively after augmentation; psychological parameters for voice and swallowing also improved.CONCLUSIONSBuccal fat augmentation to correct insufficient neoglottal closure after SCL-CHEP was technically feasible. A navigation system was helpful for confirmation. Fat absorption occurred and one third of the volume remained at 3 and 6 months. Although, vocal measurements remained unchanged, psychological parameters for voice and swallowing improved.