Clinical Efficacy Analysis Of Vertical Partial Laryngectomy Using Oral Prosthetic Membrane Repair

Background: Laryngeal cancer is a common malignant tumour of the ear,nose,throat,head and neck surgery.Among laryngeal cancers,the vocal hilar type accounts for about50% of the cases,and the incidence has been increasing in recent years.Surgery is still one of the main treatment options for laryngeal cancer.Surgical treatment that preserves the function of the larynx has become the mainstream surgical treatment for laryngeal cancer because it preserves the breathing,swallowing and articulation functions of the larynx to a certain extent.Vertical partial laryngectomy,as a kind of laryngeal function preservation surgery,is commonly used in the treatment of laryngeal cancer of the vocal fold type.The vertical partial laryngectomy ensures complete resection of the tumour while preserving as much of the normal laryngeal tissue as possible,reconstructing some or all of the physiological functions of the larynx and improving the patient’s survival quality,which is in line with the development trend of laryngeal cancer surgery.Objective: To compare the results of the new laryngeal vertical partial laryngectomy with oral prosthetic membrane repair and the traditional laryngeal vertical partial laryngectomy for patients with acoustic laryngeal cancer.To observe the effect of vertical partial laryngectomy with oral prosthetic membrane repair on the postoperative respiratory function,swallowing function and articulation function of patients with hilar laryngeal cancer.Seeking to effectively improve the recovery of respiratory function,swallowing function and articulatory function of laryngeal cancer patients after surgery and improve the survival quality of patients.To provide ENT clinicians with better ideas in vertical partial laryngectomy.Methods: A retrospective analysis of 40 patients with acoustic hilar laryngeal cancer who presented and were hospitalized in the pharyngology department of a hospital from January 2017 to October 2022,all of whom met the indications for laryngeal vertical partial laryngectomy surgery.The cases treated with traditional vertical laryngectomy in the pharyngology department of a hospital from January 2017 to September 2019 were used as the control group;the new procedure of using oral prosthetic membrane to repair the residual larynx during vertical partial laryngectomy in the pharyngology department of a hospital from October 2019 to October 2022 was carried out,and the cases using the new procedure were used as the observation group to compare the operative time,intraoperative bleeding,postoperative respiratory function,swallowing function,articulation function,postoperative complications,postoperative recurrence and 2-year tumour-free survival between the two groups.Results: There were no significant differences in age and gender between the 20 patients in the observation group and the 20 patients in the control group(P > 0.05),which were comparable.There was no statistically significant difference between the two groups in terms of operative time and intraoperative bleeding(P > 0.05).The difference in respiratory function between the two groups was statistically significant(t=-2.06,P<0.05).The mean time to extubation was significantly shorter in the observation group than in the control group,and the recovery of respiratory function after surgery was better in the observation group than in the control group.The recovery of respiratory function in the observation group was better than that in the control group.The swallowing function and articulation function of the two groups at 1 month,3 months and 6 months after surgery were statistically significant(P < 0.05).In the observation group,swallowing function and pronunciation function were significantly better than those in the control group at 1 month,3 months and 6 months after surgery.There was no significant difference in the recurrence rate,postoperative complication rate and 2-year tumour-free survival rate between the two groups at 2 years after surgery(P > 0.05).Conclusion: The laryngeal vertical resection using oral prosthetic membrane to repair the residual larynx resulted in short recovery time and good recovery of respiratory function,swallowing function and articulation function,and the incidence of postoperative complications,postoperative recurrence rate and 2-year tumour-free survival were not significantly different from those of the traditional laryngeal vertical resection.The new procedure can significantly improve the quality of patients’ postoperative survival,and is a worthy and effective surgical approach.