Asian Journal of Surgery
Volume 33, Issue 1 , Pages 14-19, January 2010

Reconstruction of Hypopharynx and Cervical Oesophagus for Treatment of Advanced Hypopharyngeal Carcinoma and Recurrent Laryngeal Carcinoma

  • Qing Xiao

      Affiliations

    • Department of Hematology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
  • Guo-Hua Hu

      Affiliations

    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Guo-Hua Hu, Department of Otolaryngology, The First Affiliated Hospital, Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing 400016, China
  • ,
  • Shi-Xun Zhong
  • ,
  • Yi Qian
  • ,
  • Quan Zeng
  • ,
  • Su-Ling Hong

Department of Otolaryngology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China

Accepted 17 March 2010.

Article Outline

Objective

To review our treatment strategy and outcomes in reconstructing the hypopharynx and cervical oesophagus with five techniques for advanced hypopharyngeal carcinoma and recurrent laryngeal carcinoma.

Methods

Thirty-one patients treated between 1996 and 2007 were analysed retrospectively. Defects of the hypopharynx and cervical oesophagus were reconstructed using the remaining laryngeal mucosa flap, pectoralis major myocutaneous flap, forearm free flap, jejunal free flap or latissimus dorsi myocutaneous flap.

Results

All patients were treated successfully. Postoperative pharyngocutaneous fistulas occurred in four patients, one of whom died from haemorrhage of carotid artery 1 month after surgery, and the other three resolved spontaneously. Dysphagia occurred in three patients, which was caused by food mass occlusion, or oesophageal stricture and stoma stricture. The 3- and 5-year survival rates were 59.3% and 43.5%, respectively.

Conclusion

A consensus treatment strategy for reconstructing the defect following hypopharyngectomy and cervical oesophagectomy has not been established. Every technique has its advantages and disadvantages. The treatment of choice depends upon the location and size of the carcinoma as well as the patient's characteristics and the doctor's experience.

Key Words:  hypopharyngeal carcinoma , laryngeal carcinoma , laryngectomy , pharyngectomy , reconstruction

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References 

  1. Tai SK , Chang SY . Contralateral hemilaryngotracheal flap reconstruction of the hypopharynx in pyriform carcinoma resection . Laryngoscope . 1999;109:221–225
  2. Fabian RL . Pectoralis major myocutaneous flap reconstruction of the laryngopharynx and cervical esophagus . Laryngoscope . 1988;98:1227–1231
  3. Kim JT . Latissimus dorsi perforator flap . Clin Plast Surg . 2003;30:403–431
  4. Scharpf J , Esclamado RM . Reconstruction with radial forearm flaps after ablative surgery for hypopharyngeal cancer . Head Neck . 2003;25:261–266
  5. Disa JJ , Pusic AL , Mehrara BJ . Reconstruction of the hypopharynx with the free jejunum transfer . J Surg Oncol . 2006;94:466–470
  6. Couch ME . Laryngopharyngectomy with reconstruction . Otolaryngol Clin North Am . 2002;35:1097–1114
  7. Hirano M , Kurita S , Tanaka H . Histopathologic study of carcinoma of the hypopharynx implication for conservation surgery . Ann Otol Rhinol Laryngol . 1981;96:625–629
  8. Katzenell U , Yeheskeli E , Segal S , et al.   Hemilaryngeal flap for hypopharyngeal reconstruction in pyriform sinus carcinoma . Acta Otolaryngol . 2007;127:4–7
  9. Rhee PH , Friedman CD , Ridge JA , et al.   The use of processed allograft dermal matrix for intraoral resurfacing . Arch Otolaryngol Head Neck Surg . 1998;124:1201–1204
  10. Barzan L , Comoretto R . Hemipharyngectomy and hemilaryngectomy for pyriform sinus cancer: reconstruction with remaining larynx and hypopharynx and with tracheotomy . Laryngoscope . 1993;103:82–86
  11. Coleman JJ . Reconstruction of the pharynx after resection for cancer. A comparison of methods . Ann Surg . 1989;209:554–560
  12. Azizzadeh B , Yafai S , Rawnsley JD , et al.   Radial forearm free flap pharyngoesophageal reconstruction . Laryngoscope . 2001;111:807–810
  13. Ayshford CA , Walsh RM , Watkinson JC . Reconstructive techniques currently used following resection of hypopharyngeal carcinoma . J Laryngol Otol . 1999;113:145–148

PII: S1015-9584(10)60003-6

doi:10.1016/S1015-9584(10)60003-6

Asian Journal of Surgery
Volume 33, Issue 1 , Pages 14-19, January 2010