喉頭癌T3例の再建の工夫:有茎舌骨筋弁を用いて Laryngeal reconstruction using contralateral osteomuseular flap after subtotal laryngectomy

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著者

    • 箕山 学 Minoyama Manabu
    • 大阪赤十字病院耳鼻咽喉科・気管食道科 Department of Otolaryngology and Bronchoesophagology, Osaka Red Cross Hospital
    • 與那嶺 裕 Yonamine Yutaka
    • 大阪赤十字病院耳鼻咽喉科・気管食道科 Department of Otolaryngology and Bronchoesophagology, Osaka Red Cross Hospital
    • 岡野 高之 Okano Takayuki
    • 大阪赤十字病院耳鼻咽喉科・気管食道科 Department of Otolaryngology and Bronchoesophagology, Osaka Red Cross Hospital
    • 田辺 正博 Tanabe Masahiro
    • 大阪赤十字病院耳鼻咽喉科・気管食道科 Department of Otolaryngology and Bronchoesophagology, Osaka Red Cross Hospital
    • 田中 信三 Tanaka Shinzou
    • 京都大学耳鼻咽喉科・頭頸部外科学教室 Department of Otolaryngology, Faculty of Medicine, Kyoto University

抄録

A reconstructive procedure was performed after subtotal laryngectomy due to T3 supraglottic carcinoma. An osteomuscular flap was designed to reconstruct the defective larynx in order to preserve the laryngeal function. In the patient, the contralateral hyoid bone, along with the sternohyoid muscle, was used to reconstruct the resulting defect. This osteomuscular flap provided bulk for the posterior glottic to prevent aspiration, while the maintenance of the glottic remnant preserved an adequate airway and phonation. Mobilized pyriform sinus mucosa and neck skin flap covered a new glottis. Early decannulation and satisfactory voice quality were archived in this case. Conservative laryngectomy means complete resection of the tumor and reconstruction of the essential laryngeal function (sphincteric, phonatory, and respiratory). The method of maintaining one movable arytenoid and one normal vocal cord during surgical treatment of T3 supraglottic carcinoma achieves the goal of satisfactorily reconstructing the essential laryngeal function.

収録刊行物

  • 喉頭

    喉頭 13(2), 78-82, 2001

    The Japan Laryngological Association

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