Objective To explore the effect of the reconstruction of laryngeal function by infracon-strictor thyroid cartilage osteoperiosteal flap repair in vertical hemi-laryngectomy for laryngocarcinoma. Methods 85 cases with early metaphase laryngeal cancer (glottis T1-3 n0-1 m0) were randomly selected. All patients were performed preoperative pathological biopsy , fiber laryngoscopy and laryngeal enhanced CT scanning diagnosis, and repaired by inferior thyroid perichondrium flap after vertical hemi-laryngectomy.The extubation time and rate , the flap mucosal epithelialization time , postoperative pronunciation and complication were observed after the surgery. Results All cases were followed up for six months to five years.85 patients were successfully pulled out after surgery , and the catheter rate was 100%.There were 12 cases of granulation in the laryngeal cavity after surgery , and the incidence rate was 14.1%.The total epithelialization time of the flap was 3 to 4 months.None of the patients were carried out a secondary operation , and none of the patients died.All cases achieved good pronounce , normal eating and daily verbal communication. Conclusions Pha-ryngeal constrictor flap is a kind of soft periosteum , which has the characteristics of convenient , easy rotation, good blood transport and quick mucosal epithelialization.It can improve the extubation rate , reduce the inci-dence of laryngeal stenosis and improve the quality of speech and survivorship in laryngeal function reconstruc -tion for the laryngocarcinoma patients underwent vertical hemi-laryngectomy.%目的 探讨垂直半喉切除咽下缩肌甲状软骨膜瓣重建喉功能的效果. 方法 随机选取早中期喉癌(声门型T1-3N0-1M0)患者85例,术前均行病理活检、纤维喉镜检查及喉部增强CT扫描明确诊断,并一期行垂直半喉切除咽下缩肌甲状软骨膜瓣修复术.术后随访复查纤维喉镜,统计术后拔管情况、皮瓣粘膜上皮化时间、术后发音情况及并发症. 结果 术后随访0.5～5年,85例患者术后均成功拔管,拔管率为100%;术后喉腔出现肉芽者12例,发生率为14.1%;术后皮瓣完全上皮化时间为3～4个月;无一例患者出现喉狭窄需行二次手术,无一例患者死亡.术后患者发音良好,均能正常进食及进行日常的言语交流. 结论 咽下缩肌甲状软骨膜瓣以咽下缩肌为蒂,甲状软骨膜为修复面,具有取材方便、易旋转、血运好及粘膜上皮化快的特点.以此为皮瓣进行喉功能重建,可有效提高术后拔管率,降低喉狭窄发生率,提高发音质量,改善患者术后的生存质量.
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