ABSTRACT
Objective To explore the efficacy of reserving thyroid cartilage combined with thyroid perichondrium flap to repair the defect of frontal-lateral window partial laryngectomy for T1b glottic cancinoma with anterior commissure involved.Methods From our hospital 22 cases diagnosed as T1b glottic cancer with anterior commissure invaded were treated with frontal-lateral window partial laryngectomy and were repaired by reserving thyroid cartilage combined with flap of thyroid perichondrium.All the patients were followed up for five years.The functions of respiratory and swallowing,voice rehabilitation,ratios of recurrence and survival were observed.Results All the patients succeeded in removing tracheal cannula.The decannulation rate was100％ and the aspiration rate was 0％.The voice functions in patients with postoperative classification (G) were higher than that of preoperative accounted for 86.4％ (19/22),and the same preoperative accounted for 13.6％ (3/22).There were 2 cases with tumor recurrence,one cases with recurrence in situ and one case with cervical lymph node metastasis.The recurrence rate was 9.1％ (2/22) and the 5 year survival rate was 95.5％ (21/22).Conclusion Frontal-lateral window partial laryngectomy reserving thyroid cartilage combined with thyroid perichondrium flap,is suitable for T1b glottic cancinoma invading anterior commissure.It can preserve the laryngeal framework and function relatively integrated with rare laryngeal stenosis and stabble repaired tissue.It also can effectively improve the sound quality and is worthy of clinical promotion.
ABSTRACT
Objective: To validate thyroid perichondrium with muscular pedicle in laryngopharyngeal repair.Methods: The thyroid perichondrium with muscular pedicle was used. in 2 cases undergoing resection of laryngopharyngeal cancer during different patterns of repair operation. Results: A 1 5 year follow up study showed that both cases achieved the goal of reparative healing. Conclusion: The advantages of this technique are easy to draw materials, good enough in blood supply, mobile for use, and benefitial to epithelializing and filling up the tissue defect. The disadvantages are the limited area and sometimes mild contraction or fibrosis. [
ABSTRACT
BACKGROUND: The various methods of the laryngeal reconstruction have been tried attesting to the challenge of minimizing complications such as aspiration, airway obstruction, and hoarseness after surgery. But, no ideal reconstruction material was found. OBJECTIVES: The purpose of this study was to determine outcomes and clinical applications after reconstruction by sternohyoid muscle with external thyroid perichondrium or its fascia following vertical hemilaryngectomy in the dogs. MATERIALS AND METHODS: Nine of 12 dogs, underwent reconstruction of laryngeal defect by bipedicled sternohyoid muscle flap with perichondrium(Group I) and muscle fascia itself(Group II), were investigated. RESULTS: Larynges were investigated for a 8-week period in perichondrium group and 32-week in fascia and were analyzed by clinical, endoscopic and histologic assessment. Author's results were summarized as follows: 1) Patent airway without aspiration was seen in all cases. 2) Under the endoscope, it was found that granulation tissue was developed in early period, but pseudocord development and position in both group were similar. 3) In the histological examination, mucosal reepithelization was done by pseudostratified squamous epithelium in the vocal cord. Although slow pseudocord development and many inflammation were seen in fascia group, similar results was found in both group in long term follow-up. CONCLUSION: The perichondial group were superior in infection, reepithelization of glottis, but similar results were seen in fascia group in long term follow-up. So fascia graft for glottic reconstruction is useful method in large laryngeal defect.
