[Clinical study about anatomical and functional reconstruction for frontolateral vertical partial laryngectomy with ultrathin titanium mesh and fascia flap from the strap muscles].

ABSTRACT

Objective:To investigate the effect of laryngeal reconstruction in functional and anatomical aspect with ultrathin titanium mesh and myofascial flap in patients underwent frontolateral vertical partial laryngectomy with T2 and T3 glottic laryngeal carcinoma. Method:Ten patients with T2 and T3 glottic laryngeal carcinoma underwent frontolateral vertical partial laryngectomy in different range. The ultrathin titanium mesh was shaped up according to the form of thyroid cartilage in operation while the thyroid perichondrium membrane combined with straped myofascial flap was lined under the titanium mesh to restore the laryngeal cavity space. The pronunciation, swallowing capability and extubation rate were observed after surgery. Result:Nine patients underwent extubation within 2 to 4 weeks after surgery, one patients remove metal tube in two-stage after laryngeal dilation surgery with the Montgomery tube. Swallowing and voice function in these patients recovered well and no deglutition disorder was found. CT scan showed that the Titanium meshs were fixed well without displacement and deformity. Electronic laryngoscopy showed that the mucosa of laryngeal lumen was smooth without laryngeal stenosis, keloid contraction, tissue necrosis or titanium mesh exposure. Conclusion:In the cases of T2, T3 glottic laryngeal cancer patients, laryngeal framework reconstruction with the new type of ultrathin titanium mesh, thyroid cartilage membrane and pedicled fascia plap of strap muscles is a good choice after the vertical frontolateral partial laryngectomy. Even some elective T4 cases with the former part invasion in supra-glottic or infra-glottic region can receive this operation. It can reconstruct the physiological and anatomical structure of the larynx, restore laryngeal function with a sound decanulization rate.