The Curative Effect Analysis Of Bi-pedicle Muscular And Thyroid Cartilage Membrane Flap In Clinical Practice

Objective:To analyze the curative effect of bi-pedicle muscular and thyroid cartilage membrane flap used for the reconstruction of partial laryngectemy, and to evaluate the advantages and disadvantages of bi-pedicle muscular and thyroid cartilage membrane flap for the laryngeal functional reconstruction. Summarize the matters needed attention to guide its clinical application in otolaryngology head and neck surgery, especially laryngeal surgery.Methods:The cases from January 2011 to December 2015 underwent the surgery of vertical hemi-laryngectomy in our department were selected, and were?phase reconstructed by using bi-pedicle muscular and thyroid cartilage membrane flap. There was a total of 30 cases. 19 of them took ipsilateral or bilateral selective cervical lymph node(?~? area)dissection. Following up the cases through the outpatient clinic visits, contact with them by telephone or other way after the surgery. There is no one lost to follow-up in these patients. We record their survival situation after operation, postoperative days pulling tracheotomy and nasogastric tube, the postoperative hospitalization days, trachea cannula extubation rate, pronunciation recovery and eating function recovery after surgery, etc. In the end,we came to the conclusion by analyzing the repair operation condition in our department.Results:The patients into the group with postoperative follow-up time is about three months to five years. Twenty-six patients smoothly pulled up tracheal tube in twelve to sixty-five days after operation, and the extubation rate was 86.7%. Patients are satisfied with the basic pronunciation what makes them communicate with people normally, and breathing smoothly. Eight to thirty days after operation, all of the thirty cases were successfully pulling nasogastric tube, eat through the mouth completely. Swallowing in patients with satisfactory results and just one patient has slightly aspiration while the rest have no obvious aspiration. One patients get laryngeal fistula because of early postoperative through the mouth eating. He was cured after conservative treatment such as the unobstructed drainage treatment and anti-infection. Three cases of postoperative recurrence in three to twelve months were readmission and have taken the total laryngectomy.Conclusion:Because of the high rate of postoperative extubation, pronunciation function satisfaction, low incidence and the light degree of aspiration, bi-pedicle muscular and thyroid cartilage membrane flap used for reconstructing laryngectomy has high clinical value. It is a satisfactory way in partial resection of laryngeal function reconstruction. It is worth to learn and promote for laryngeal surgical colleagues. As long as we strictly grasp the indications, according to the specific intraoperative situation to choose the appropriate restorative materials, when necessary joint other repair materials for laryngeal function reconstruction, patients will get good quality of life and return to the social life at an early date.