PDF(Pubmed)
Abstract：
UNASSIGNED: Glottic tumors with infiltration of the anterior/posterior commissure, and lesions with subglottic, cricoid, or cricoarytenoid joint infiltration have been highly controversial in the past, from the perspective of oncological safety. Although conservation laryngeal resection options exist, most are limited by the extent of resection proscribed by the technique and the postoperative functional results. Oncologically speaking, extended vertical hemilaryngectomy is often the optimal solution. However, limited reconstruction methods often compel total laryngectomy.
UNASSIGNED: Eight patients with vocal fold malignancy, which infiltrated the anterior and sometimes the posterior commissure and with subglottic extension and resultant uni/bilateral vocal fold motion impairment, were treated by single stage extended vertical partial laryngectomy with rotational crico-thyrotracheopexy as a functional reconstruction of the laryngeal framework. Patients were evaluated with objective and subjective function tests.
UNASSIGNED: Histologic examination demonstrated tumor-free margins in every case. Definitive decannulation was successful in all cases within 2 weeks. All patients had a stable and adequate airway during follow-up and reported socially acceptable voice. Oral feeding was possible in seven patients.
UNASSIGNED: Rotational crico-thyrotracheopexy, as a single stage reconstruction technique, is based on well-vascularized, readily available, appropriately shaped local tissues, without significant donor site morbidity or need for long-term stenting to reconstruct large laryngeal defects after extended vertical hemilaryngectomy for advanced unilateral glottic tumors and is applicable even with supra/subglottic invasion or infiltration of the contralateral vocal fold. An adequate airway can be achieved with socially acceptable voice and safe swallowing without compromising oncologic reliability.
UNASSIGNED: 4 (retrospective case series review).
UNASSIGNED: Eight patients with vocal fold malignancy, which infiltrated the anterior and sometimes the posterior commissure and with subglottic extension and resultant uni/bilateral vocal fold motion impairment, were treated by single stage extended vertical partial laryngectomy with rotational crico-thyrotracheopexy as a functional reconstruction of the laryngeal framework. Patients were evaluated with objective and subjective function tests.
UNASSIGNED: Histologic examination demonstrated tumor-free margins in every case. Definitive decannulation was successful in all cases within 2 weeks. All patients had a stable and adequate airway during follow-up and reported socially acceptable voice. Oral feeding was possible in seven patients.
UNASSIGNED: Rotational crico-thyrotracheopexy, as a single stage reconstruction technique, is based on well-vascularized, readily available, appropriately shaped local tissues, without significant donor site morbidity or need for long-term stenting to reconstruct large laryngeal defects after extended vertical hemilaryngectomy for advanced unilateral glottic tumors and is applicable even with supra/subglottic invasion or infiltration of the contralateral vocal fold. An adequate airway can be achieved with socially acceptable voice and safe swallowing without compromising oncologic reliability.
UNASSIGNED: 4 (retrospective case series review).
摘要：
■伴有前/后连合浸润的声门肿瘤，和声门下病变，环状软骨,或环节骨关节浸润在过去一直备受争议，从肿瘤安全的角度来看。尽管存在保守性喉部切除术的选择，大多数受该技术禁止的切除范围和术后功能结果的限制。从肿瘤学上讲，扩大垂直半喉切除术通常是最佳方案。然而,有限的重建方法通常迫使全喉切除术。
■八位声带恶性肿瘤患者，浸润前连合，有时浸润后连合，声门下延伸，并导致单/双侧声带运动障碍，通过单阶段扩展垂直部分喉切除术和旋转环甲状腺切除术作为喉框架的功能重建。通过客观和主观功能测试对患者进行评估。
■组织学检查均显示无瘤边缘。在所有情况下，在2周内均能成功拔管。所有患者在随访期间都有稳定和充足的气道，并报告了社会可接受的声音。7例患者可以口服喂养。
■旋转环甲状腺切除术，作为一种单级重建技术，基于良好的血管化，随时可用，适当形状的局部组织，对于晚期单侧声门肿瘤，在扩展的垂直半喉切除术后，没有明显的供体部位发病率或需要长期支架来重建大的喉缺损，即使在声门上/声门下浸润或对侧声带浸润的情况下也适用。可以通过社会可接受的声音和安全吞咽来实现适当的气道，而不会损害肿瘤学的可靠性。
■4（回顾性病例系列回顾）。
■八位声带恶性肿瘤患者，浸润前连合，有时浸润后连合，声门下延伸，并导致单/双侧声带运动障碍，通过单阶段扩展垂直部分喉切除术和旋转环甲状腺切除术作为喉框架的功能重建。通过客观和主观功能测试对患者进行评估。
■组织学检查均显示无瘤边缘。在所有情况下，在2周内均能成功拔管。所有患者在随访期间都有稳定和充足的气道，并报告了社会可接受的声音。7例患者可以口服喂养。
■旋转环甲状腺切除术，作为一种单级重建技术，基于良好的血管化，随时可用，适当形状的局部组织，对于晚期单侧声门肿瘤，在扩展的垂直半喉切除术后，没有明显的供体部位发病率或需要长期支架来重建大的喉缺损，即使在声门上/声门下浸润或对侧声带浸润的情况下也适用。可以通过社会可接受的声音和安全吞咽来实现适当的气道，而不会损害肿瘤学的可靠性。
■4（回顾性病例系列回顾）。
