早期声帯癌声帯切除後における仮声帯移動術

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  • Surgical Displacement of the False Cord to Replace the Excised Vocal Cord with Early Carcinoma
  • ソウキ セイタイ ガン セイタイ セツジョゴ ニ オケル カリ セイタイ イド

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For early cancer of the vocal cord, cordectomy is one of the first choice among the successful surgical procedures. A very high cure rate has been reported when the lesion is confined to the membranous cord and the motion of the cord is not impaired. Although there has been a notable decline in the use of cordectomy due to the success of radiation therapy, a better survival rate is still obtained by cordectomy rather than by radiation according to our own experiences.<br>Hence, it is reasonable to consider that cordectomy should be more widely performed if excellent voice quality can be obtained postoperatively. From this viewpoint, we designed a new phonosurgical procedure to mobilize the false cord to replace the vocal cord after cordectomy.<br>After conventional laryngofissure and cordetomy, an incision is made into the false cord in order to make a flap which is to be used to replace the excised vocal cord. The displaced false cord flap is sewn by a fine suture under a microscope. The flap should be as thick as possible and should be sutured so that it protrudes as much as possible.<br>This newly disigned procedure has been employed for 7 cases. In this paper, the results are presented and discussed particularly from the viewpoint of phonodynamics. Considering the problems of late radiation change and possible oncogenesis, we believe that this functional microsurgery must be most appropriate for the treatment of early carcinoma of the vocal cord especially for patients of relatively young age.

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