Carcinoma of the posterior wall of the hypopharynx: surgical treatment with larynx preservation

Başaran, Bora; Ünsaler, Selin

doi:10.1016/j.bjorl.2020.05.013

Cited by 4 publications

(2 citation statements)

References 19 publications

(27 reference statements)

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“…In recent years, the treatment strategy for advanced-stage cancers has prioritized laryngeal conservation, with a positive result of 5-year survival time nearly equivalent to that of surgery, and the ability to live with a functional larynx [ 4 ]. The posterior hypopharyngeal wall is the rarest site for hypopharyngeal carcinomas, while the most common location is the pyriform sinus followed by the posterior cricoarytenoid region [ 11 , 12 ]. Therefore, there are only a few studies published in the literature specifically concerning carcinoma of the posterior wall of the hypopharynx (CPWH).…”

Section: Discussionmentioning

confidence: 99%

“…Otherwise, hypopharyngeal defects required reconstructive flaps such as anterolateral thigh (ALT)/radial forearm (RF) free flaps or pectoralis major/infrahyoid pedicled flaps. Bora et al [ 12 ] reported 10 cases of T2–T3 posterior hypopharyngeal (9 patients had T3 lesions and 1 patient had a T2 lesion). The preferred hypopharynx approach was a lateral pharyngotomy using reconstructive RF free flap, with average follow-up period of 38.3 months.…”

Section: Discussionmentioning

confidence: 99%

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Total Pharyngo-Laryngo-Cervical-Esophagectomy with Jejunal Free Flap Reconstruction in a Developing Country: A Case Report from Vietnam

et al. 2022

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Patient: Male, 52-year-old Final Diagnosis: Hypopharyngeal cancer Symptoms: Dysphagia Medication:— Clinical Procedure: Surgery and radiotherapy Specialty: Oncology • Surgery Objective: Rare disease Background: Esophageal invasion in hypopharyngeal cancer is an uncommon lesion and has a poor prognosis. Total pharyngo-laryngo-esophagectomy is the most effective treatment option. Reconstruction of the gastrointestinal tract in the same period of surgery is required. There are many different options, such as pedicle flap, gastric pull-up, pedicled transverse colon flaps, and free flap. In cases where only cervical esophagectomy is required, with benefits for patients, jejunal free flap is the first choice to reconstruct the esophagus. However, the extensive surgical resection requires interdisciplinary collaboration among surgical specialities, which is not always available. Case Report: A 52-year-old male patient came to us with a chief concern of dysphagia, which first appeared 3 months ago. Rigid fiberoptic and direct laryngoscopes indirectly observed the tumor at the posterior wall; it had passed the esophagus opening and infiltrated to the cervical esophagus, with the rightmost part spread into the right pyriform sinus. Histopathology studies of the tumor showed a squamous cell carcinoma. The patient underwent total pharyngo-laryngo-cervico-esophagectomy, reconstructed with a jejunal free flap, and adjuvant radiation therapy after surgery. At follow-up 1 year after surgery, the patient was significantly recovery with no signs of tumor recurrence, no difficulties of oral intake, and his speech was restored by electrolarynx. Conclusions: We reported the case of a patient with hypopharyngeal cancer who underwent total pharyngo-laryngo-cervicoesophagectomy and esophagus reconstruction using a jejunal free flap, performed for the first time in Vietnam. As expected, with good oncological and functional results, the degree of invasiveness and sequelae of the surgery can be well tolerated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Total Pharyngo-Laryngo-Cervical-Esophagectomy with Jejunal Free Flap Reconstruction in a Developing Country: A Case Report from Vietnam

et al. 2022

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Neoadjuvant chemotherapy and transoral robotic surgery for the posterior pharyngeal wall carcinoma

Costantino

Meliante

Sampieri

et al. 2023

Eur Arch Otorhinolaryngol

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Application of prolonged submental perforator flap to repair the postoperative defect of upper airway malignancy

Ma,

Zhong,

Hou

et al. 2023

Eur Arch Otorhinolaryngol

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Objectives To explore the feasibility of making a submental perforator flap distal to the connecting line between the mastoid and the sternoclavicular joint under the guidance of neck-enhanced CT and repairing the postoperative defect of upper airway malignancy. Materials and methods This study retrospectively analysed 19 cases of upper airway malignant tumours treated in our department from January 2021 to September 2022, including 17 males and 2 females, aged 43–70 years. Site of lesions 15 cases were in the laryngopharynx, 2 cases in the nasal cavity and paranasal sinus and 2 cases on the soft palate. All the lesions were malignant and at stages T2–4N0–2M0. Surgical method The extended submental perforator flap (size 22–15 × 6–7 cm) was prefabricated distal to the connecting line between the mastoid and the sternoclavicular joint. After tumour resection, the flap was used to repair the postoperative defect. Fifteen cases of laryngopharyngeal malignant tumours were repaired using the extended submental perforator flap with the vascular pedicle located on the opposite side of the tumour body. Two cases of nasal cavity and paranasal sinus tumours were repaired using the extended submental perforator flap combined with the temporalis muscle flap. The soft palate was completely removed in two patients with soft palate cancer and repaired using the folded extended submental perforator flap. Results Before the surgery, the reflux vein was observed by neck-enhanced CT, including 12 cases returning to the internal jugular vein and 7 cases to the external jugular vein. All 19 cases in which flaps were used survived, and 1 case had a postoperative infection. All the patients had nasal feeding removed after surgery. The tracheal cannula was removed from the patients with laryngeal preservation, and the pronunciation was satisfactory. Among them, patients with soft palate cancer repair had mild nasal reflux symptoms with smooth breathing. During the follow-up period of 4–24 months, 18 patients had no tumour recurrence or metastasis, and 1 patient had cervical lymph node metastasis. Conclusions This study highlights the use of a submental perforator flap distal to the connecting line between the mastoid and the sternoclavicular joint to repair postoperative defects for upper airway malignancy as an innovative surgical approach that provides more tissue and good arteriovenous blood supply to adjacent sites. This method has high clinical value and provides an effective option for repairing postoperative defects of upper airway malignancy.

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Carcinoma of the posterior wall of the hypopharynx: surgical treatment with larynx preservation

Cited by 4 publications

References 19 publications

Total Pharyngo-Laryngo-Cervical-Esophagectomy with Jejunal Free Flap Reconstruction in a Developing Country: A Case Report from Vietnam

Total Pharyngo-Laryngo-Cervical-Esophagectomy with Jejunal Free Flap Reconstruction in a Developing Country: A Case Report from Vietnam

Neoadjuvant chemotherapy and transoral robotic surgery for the posterior pharyngeal wall carcinoma

Application of prolonged submental perforator flap to repair the postoperative defect of upper airway malignancy

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