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
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.
喉頭 13(2), 78-82, 2001
The Japan Laryngological Association