Surgical treatment of T2-3 posterior hypopharyngeal carcinoma with preservation of laryngeal function

Abstract

Background

Posterior hypopharyngeal carcinoma indicates a poor prognosis. Previous treatments predicted negative influence to the pronunciation and swallowing function. The present study focuses on improving survival rate while improving quality of life.

Aim

To investigate on the surgical techniques of the preservation of laryngeal function of posterior hypopharyngeal carcinoma.

Methods

Eighteen patients with posterior hypopharyngeal carcinoma of T2-T3 were studied. All primary lesions were removed and the defects were repaired with the radial forearm free flap (RFFF).

Results

The 3-year overall survival rate was 51.9%. All patients could maintain daily caloric intake by feeding orally, and remove the gastric tube 28–61 days after operation. Assessed swallowing function by Fiberoptic endoscopic evaluations of swallowing. When eating solid food, 66.67% patients had food residue; no food entered airway, and all patients had Penetration-Aspiration Scale of level 1. As for liquid, 11.11% patients had level 5, 16.67% level 4, 27.78% level 2 and 44.44% level 1.

Conclusions

By preserving the integrity of larynx and superior laryngeal nerve with repairing the defects of posterior wall of hypopharynx with RFFF, patients with T2 and T3 stage posterior hypopharyngeal carcinoma could live a better quality of life.

Chinese abstract

背景：后咽癌意味着不良的预后。以前的治疗预测对发音和吞咽功能的负面影响。本研究重点在于提高生活质量的同时提高生存率。

目的：探研后咽癌医治中保留喉功能的手术技术。

方法：研究了 18 例 T2-T3 期后咽癌患者。切除所有原发病变, 并用前臂桡骨游离皮瓣（RFFF）修复缺损。

结果：3年总生存率为51.9%。所有患者均能通过口服维持每日热量摄入, 术后28-61天拔除胃管。通过光纤内窥镜评估吞咽功能。进食固体食物时, 66.67%的患者有

食物残渣；没有食物进入气道, 所有患者的穿透-吸入量表均为 1 级。至于液体, 患者中11.11% 为 5 级, 16.67% 为 4 级, 27.78% 为 2 级, 44.44% 为 1 级。

结论：通过修复喉部和喉上神经的完整性, 用RFFF 治疗下咽后壁缺损, T2 和 T3 期后咽癌患者可以过上质量更好的生活。

Keywords:

• Radial forearm free flap
• posterior hypopharyngeal wall
• squamous cell carcinoma
• laryngeal preservation
• hypopharynx reconstruction

Acknowledgment

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Disclosure statement

No potential conflict of interest was reported by the author(s).