Priliminary study of pedicled sternocleidomastoid clavicular periosteocutaneous flap to repair the laryngotracheal defect
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摘要: 目的:探讨带蒂胸锁乳突肌锁骨骨膜皮瓣修复肿瘤切除术后喉气管缺损的可行性。方法:回顾2007-2013年6例因甲状腺乳头状癌(4例)及声门下喉鳞状细胞癌(6例)(T1~2N1~2M0,UICC,2002)手术切除致喉气管部分缺损病例,以带蒂胸锁乳突肌锁骨骨膜皮瓣修复喉气管缺损区,术腔置喉模支撑成形,术后半年,如局部无复发,气管套管堵管无困难,则拔管封闭气管造瘘口。随访半年~3年。结果:6例患者中4例顺利拔管,1例间断堵管,1例保留气管套管呼吸。结论:选择适当病例,用带蒂胸锁乳突肌锁骨骨膜皮瓣可以修复喉气管部分缺损,在发音和呼吸方面达到满意的临床效果。Abstract: Objective: To investigate the feasibility of utilizing pedicled sternocleidomastoid clavicular periosteocutaneous flap to reconstruct the laryngotracheal defect after tumor resection. Method: To review 6 cases of laryngotracheal defect resulting from resction of thyroid papillary carcinoma(4/6) or subglottic laryngeal carcinoma(2/6) (T1~2N1~2M0,UICC,2002), laryngotracheal stenting was also employed in all cases. Half a year after surgery, the stoma was sutured if no local recurrence took place and safety was proved after tracheal tube had been obstructed for days. The follow-up time lasted from half a year to 3 years. Result: Four cases (4/6) were extubated successfully without event, one case could intermittently plug the tracheal tube. One patient couldn't breath with tracheal tube plugging. Conclusion: To reconstruct the laryngotracheal defect with pedicled sternocleidomastoid clavicular periosteocutaneous flap after tumor resection is feasible in selected cases and could get satisfactory clinical results either in respiration or phonation.
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Key words:
- larynx tumor /
- trachea /
- defect /
- reconstruction /
- sternocleidomastoid muscle
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