Clinical Application Of V-shaped Laryngeal Silica Gel Membrane In Early Glottic Laryngeal Carcinoma

Objective:This study aims to explore application value and curative effect of Vshaped laryngeal silica gel membrane placement in double side glottic laryngeal carcinoma after laryngofissure.Materials and Methods:A total of 60 patients with glottic laryngeal carcinoma on T1-T2 stage from July 2012 to January 2015 treated in our department in were included among which 58 of them were men and the rest were women. All of them accepted laryngofissure, 34 postoperative patients were placed T-shaped silicone membrane, while 26 postoperative patients were placed V-shaped silica gel membrane. Perioperative treatments are the same. One month after postoperative those with wide glottis area via electronic fiber laryngoscope inspection would be removed the laryngeal silica gel membrane under local or surface anesthesia. Comparatively analyzing five differences that are postoperative pain degree, respiratory function, and phonation function, swallowing function and mucosa recovery in two group patients who were placed in different materials. Hospitalization time was about 9 days and discharge follow-up for 6 months.Result:All of the sixty patients were accepted laryngofissure to remove tumor and laryngeal silica gel membrane implantation, both of means resected lesions in one time. Compared postoperative pain degree via using numeric rating scales(NRS), there were 6 cases of them had no pain, 24 cases had mild pain and 4 cases had moderate pain in T-shaped silicone membrane group and there were 11 cases had no pain, 15 cases had mild pain and no moderate and severe pain cases in V-shaped silicone membrane group. There exited significant difference between the two groups(P<0.05). Compared respiratory function: In the T-shaped silicone membrane group, 32 patients received extubation and 2 of them did not. So decannulation rate was 94.1%. However decannulation rate of the V-shaped silicone membrane group was one hundred percent. Compared swallowing function, two group patients’ abnormal deglutition degrees were mild. 30 cases were in level 0 and 4 in level one in the Tshaped silicone membrane group, while 24 cases were in level 0 and 2 in level one in the V-shaped silicone membrane group. And there was no significant between that of both groups(P>0.05). In gastric tube removed time, the T-shaped silicone membrane group was longer than that of the V-shaped silicone membrane group; the differences between the two groups have statistical significance(P<0.05). Compared phonation function, the mean of Voice Handicap Index(VHI) in the T-shaped silicone membrane group was 21.13±6.10, when that in the V-shaped silicone membrane group was 18.36±7.28; the differences between the two groups have statistical significance(P< 0.05). Most patients in both groups are mild-to-moderate abnormal degree(about 1 to 2 degree) when compare the index of Total hoarse voice degree G score. That of the Tshaped silicone membrane group was 82.35% and the other group is 96.15%; Difference between two groups on total hoarse voice degree G score was statistically significant(P<0.05).Conclusion : This study proved that silica gel membrane implantation can effectively avoid laryngeal stenosis due to scarring caused by glottic laryngeal carcinoma after bilateral vocal cord lesions resection, effectively relieve the patient’s voice state with small postoperative pain, rapid recovery and fewer complications. Considering from the aspect of normal glottis structure, vocal cords restore and normal form of glottis area, the new V-shaped silica gel membrane has greatly improved the postoperative laryngeal function recovery and survival quality of patients.