Total Laryngectomy Technique | 合法醫療器材資訊網

2018年9月10日—Complications·Hematoma/Seroma·WoundDehiscence·WoundInfection·PharyngocutaneousFistula·StomalStenosis.

A Foley catheter and an A-line are placed for hemodynamic monitoring. The patient is prepped with Betadine or a similar antiseptic solution from the mentum to the sternum anteriorly and from the body of the mandible/mastoids to the clavicles laterally. Perioperative antibiotics with coverage against gram-positive organisms and anaerobes should be administered prior to skin incision.

If a neck dissection[1] is planned in conjunction with a laryngectomy, then an apron incision is planned extending from both mastoid processes to approximately 2 fingerbreadths above the level of the sternal notch. If no neck dissection is planned, then a narrower incision may be used. The planned incision is injected with 1% lidocaine with 1:100,000 epinephrine. The incision is made with a 15-blade scalpel or Bovie electrocautery on cut mode.

Dissection is carried down through the platysmal muscle. A ...