Clinical Study On Sternohyoid Muscle Flap In Reconstruction Of Laryngeal Vocal Cord

Objective:To analyse the clinical results of reconstruction of the vocal cord using sternohyoid muscle flap after partial laryngectomy and research a new repairing method to improve laryngeal function and Living quality of patient.Method:The pronunciation of larynx is on the basic of the vibration of the vocal cord by air current. The laryngeal appearance and the function of opposite side vocal cord is very important for improving the quality of pronunciation. We developed a technique of thyroid cartilage membrane and sternohyoid muscle flap to repair the defect left behind after a vertical laryngectomy and reconstructe the vocal cord. The thyroid cartilage membrane was used to bridge over the upper part defect of laryngeal cavity, the sternohyoid muscle flap froming the opposite side was made a 90 degree bent toward the laryngeal cavity to repaire the lower part defect of laryngeal cavity and reconstruct a new vocal cord. The repaired larynx recoved the normal appearance. The new vocal cord participated speech. The anterior 2/3 part of both vocal cored could contacted in pronunciation of patient. The phonation function of larynx was restored.Results:76 cases partial laryngectomy was taken including vertical partial laryngectomy 37 cases, extended vertical partial laryngectomy 24 cases, three-fourths laryngectomy 15 cases. During their operations, the Laryngeal defect was repaired with thyroid cartilage membrane and sternohyoid muscle flap, and a vocal cord was reconstructed in the same time. After operation, the laryngeal cavity repaired has anormal appearance, and the laryngeal satisfactory phonation effect has been obtained. 92.1% of the patients enjoyed a socially acceptable voice and rejoined normal working.The three and five year survival rates for glottic type were 91 %(5 1 in 56) and 86.1%(31 in 36) respectively, and for supralottic type, 78.6% (11 in 14) and 66.7% (8 in 12). The deeannulation rate was 90.2%(glottic type) and 80%(supraglottic type). All cases resumed normal mouth-food-taking.Conclusion:A technique of thyroid cartilage and sternohyoid muscle flap to repair the defect and reconstructive vocal cord after partial laryngectomy make patient recover normal laryngeal appearance and obtain satisfactory phonation effect. Among the method of repairation for partial laryngectomy sternohyoid muscle flap should be first considered owing to its venous merits: (1) abundant material. (2) Convenient procedures.(3) smaller trauma. (4) satisfactory effect.