下咽頭部分切除における声門上部の硬的再建術  [in Japanese] Reconstruction of the Supraglottis after Partial Laryngopharyngectomy  [in Japanese]

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Author(s)

    • 田中 信三 TANAKA Shinzo
    • 京都大学医学部耳鼻咽喉科・頭頸部外科 Department of Otorhinolaryngology-Head & Neck Surgery, Kyoto University School of Medicine
    • 平塚 康之 HIRATSUKA Yasuyuki
    • 京都大学医学部耳鼻咽喉科・頭頸部外科 Department of Otorhinolaryngology-Head & Neck Surgery, Kyoto University School of Medicine
    • 安里 亮 ASATO Ryo
    • 京都大学医学部耳鼻咽喉科・頭頸部外科 Department of Otorhinolaryngology-Head & Neck Surgery, Kyoto University School of Medicine
    • 伊藤 壽一 ITO Juichi
    • 京都大学医学部耳鼻咽喉科・頭頸部外科 Department of Otorhinolaryngology-Head & Neck Surgery, Kyoto University School of Medicine

Abstract

喉頭の声門上部を合併切除する梨状陥凹癌の下咽頭部分切除において誤嚥を防止する手術法を考案した。患側の喉頭蓋と披裂部を切除後,舌骨半部を胸骨舌骨筋が付着したまま甲状軟骨と喉頭蓋軟骨に固定し喉頭蓋を再建する。胸骨舌骨筋を健側の披裂部断端に縫合して披裂部の隆起を形成する。遊離前腕皮弁を用いて,再建した声門上部を被覆し,梨状陥凹を再建する。<br>本手術を梨状陥凹癌T2N0例に行った。術後3週目に気切口を閉鎖し経口摂食を開始した。術後,音声は正常であった。呼吸機能も嚥下機能も良好で,呼吸困難や誤嚥は生じなかった。

We developed a new surgical method to prevent aspiration after partial laryngopharyngectomy for piriform sinus carcinoma. After removing the epiglottis and arytenoid on the affected side, half of the hyoid bone connecting to the sternohyoid muscle was fixed to the thyroid and the epiglottic cartilages to reconstruct the epiglottis. A protrusion of the arytenoid was formed with the sternohyoid muscle sutured to the excised end of the arytenoid on the unaffected side. Using a free forearm flap, the supraglottis was covered, and the piriform sinus was reconstructed.<br>This surgery was performed for a patient with T2N0 piriform sinus carcinoma. Three weeks after surgery, the tracheal stoma was closed and the oral intake of food was begun. The voice was normal. The respiratory and swallowing functions were satisfactory without any dyspnea or aspiration.

Journal

  • Nihon Kikan Shokudoka Gakkai Kaiho

    Nihon Kikan Shokudoka Gakkai Kaiho 53(3), 275-279, 2002-06-10

    The Japan Broncho-esophagological Society

References:  5

Cited by:  6

Codes

  • NII Article ID (NAID)
    10008579649
  • NII NACSIS-CAT ID (NCID)
    AN00187474
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    00290645
  • Data Source
    CJP  CJPref  J-STAGE 
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