Clinical Study Of Thyroid Cartilage Window Drawer Resection And Titanium Plate Internal Fixation For Reconstruction Of Laryngeal Function In Early Glottic Carcinoma

Objective:To consider the reconstruction of laryngeal function comprehensively,it is an eternal pursuit and goal that not only the tumors should be removed thoroughly,but also the laryngeal function should be repaired as far as possible,so as to improve the quality of life of patients.The purpose of this study was to investigate the clinical study of laryngeal function reconstruction with mini-titanium plate internal fixation after window-opening drawer resection of thyroid cartilage in early glottic carcinoma.Methods:A total of 47 patients with glottic laryngeal cancer were treated in our department from January 2014 to October 2018.Thyroid cartilage fenestration group?TCFG?and sternohyoid muscle and its fascia repair group?SMRG?were treated with thyroid cartilage fenestration group?TCFG?.Twenty-two cases were TCFG and 25cases were SMRG.There were 46 males and 1 females,aged 43⁸0 years,with an average age of?60.55±7.19?years.According to the TNM staging criteria of the Joint American Cancer Commission?AJCC?in 2012,there were 123 cases of T_1aN₀M₀?14 cases of TCFG,9 cases of SMRG?,16 cases of T_1bN₀M₀?5 cases of TCFG,11 cases of SMRG?,and 8 cases of T₂N₀M₀?3 cases of TCFG,5 cases of SMRG?.47cases were squamous cell carcinoma.In the middle or slightly partial to the healthy side of the thyroid cartilage and 1/3 of the open window in the affected side,1/3 of the soft tissue in the affected side,tumors,and parts of the larynx were removed in the lower drawer.According to local conditions,the tissue on the glottis and the upper 1/3 thyroid cartilage plate were moved down,and the mucosal margin of the upper glottis and the subglottic region were sutured to correct the defect of the laryngeal cavity of the affected side,and the micro-titanium plate was placed inside the thyroid cartilage plate.Fixed,one-stage reconstruction of the laryngeal function.The vocal function,swallowing function,respiratory function and postoperative extubation rate of the postoperative patients were analyzed retrospectively.Results:Patients were followed up by duration of hospitalization?clinic and telephone,and the follow-up period was 4 months to 5 years.The postoperative pronunciation function,respiratory function?extraction of tracheal cannula and time?,swallowing function?stomach removal time and whether or not swallowed and cough?and survival?recurrence,metastasis,death?were collected.The thyroid cartilage fenestration-assisted micro-titanium plate internal fixation laryngeal function reconstruction for the treatment of early glottic laryngeal cancer,for the recovery of postoperative pronunciation function,language communication has obvious advantages,2 cases with normal pronunciation and 20 cases with good pronunciation,the difference in pronunciation function between the SMRG group and the SMRG group was statistically significant?P<0.05?.In the TCFG group,22cases were removed from the tracheal cannula,and the extubation time was 10 to14 days.The breathing was stable and the extubation rate was 100%.The recovery of respiratory function in patients was statistically significant?P<0.05?.Both surgical methods can promote the recovery of postoperative swallowing function.There was no significant difference in swallowing function between TCFG group and SMRG group?P>0.05?.One case of TCFG group was followed up for recurrence of cervical lymph node dissection and total laryngectomy.The SMRG group was followed up for 4 cases of recurrence,1 case of partial laryngectomy was performed,and 3 cases underwent total laryngectomy.The case died of systemic metastasis.There was no significant difference in survival between TCFG group and SMRG group?P>0.05?.Conclusion:The thyroid cartilage window and drawer resection early stage of glottic laryngeal cancer assisted micro titanium plate internal fixation to reconstruct the laryngeal function,less growth of granulation,postoperative wound healing,and basically retain the physiological shape of the laryngeal cavity.?1?Postoperative pronunciation function is better than sternohyoid muscle group;?2?The postoperative extubation rate was higher than that of the sternohyoid muscle group;?3?The postoperative swallowing function was good,no misdiagnosis and coughing occurred,and there was no difference compared with the sternohyoid muscle group;?4?There was no difference in postoperative survival between the two groups.