A Clinical Study of Head and Neck Tumors Involving the Superior Mediastinum.
- Author:
Young Min KIM
1
;
Young Ah KOO
;
Ki Young PARK
;
Young Soo RHO
;
Young Min PARK
;
Hyun Jun LIM
Author Information
1. Department of Otolaryngology-Head and Neck Surgery, Hallym University, College of Medicine, Seoul, Korea. KNENT@chollian.net
- Publication Type:Original Article
- Keywords:
Superior mediastinum;
Head and neck cancers
- MeSH:
Clavicle;
Esophageal Neoplasms;
Goiter, Substernal;
Head*;
Humans;
Hypopharyngeal Neoplasms;
Laryngeal Neoplasms;
Manubrium;
Mediastinum*;
Mortality;
Neck*;
Postoperative Complications;
Recurrence;
Retrospective Studies;
Sternotomy;
Thyroid Gland;
Thyroid Neoplasms
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
1999;42(7):891-897
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Traditionally, approaches to the superior mediastinum for head and neck surgeons are mainly limited to stomal recurrence. Recently, the need to approach to the superior mediastinum is increasing due to increasing thyroid surgery by head and neck surgeon. This study was designed to evaluate the approaches to mediastinum in head and neck tumors involving the superior mediastinum and to analyse the outcome of surgery in terms of morbidity and mortality. MATERIALS AND METHODS: At the department of otolaryngology-head and neck surgery of Hallym university, 15 patients who had been diagnosed as head and neck tumors involving the superior mediastinum from May 1990 to August 1998 were evaluated retrospectively. RESULTS: Of the 15 patients, the tumors involving the superior mediastinum were thyroid cancer (5 cases), hypopharyngeal cancer (4 cases), cervical esophageal cancer (2 cases), laryngeal cancer (1 case), and substernal goiter (3 cases). The surgical techniques used for approach to the superior mediastinum were suprasternal approach, clavicle resection, median sternotomy, and sternal manubrium resection. Eight patients are alive without recurrence, one patient is alive with disease, and six patients died, among them, four patients died of postoperative complication and two died of recurrent cancer. CONCLUSION: The mediastinal approach in itself is not complex and dangerous, however, in the treatment of head and neck cancers involving mediastinum, the surgeon should be careful in choosing the surgical method and approach. The surgeion should also take into consideration morbidity and mortality of the surgery, degree of tumor invasion and others, such as age of the patient.
