OBJECTIVE: To study the effectiveness of preserving laryngeal function for senile hypopharyngeal cancer patientsolder than 65. METHOD: The clinical data of 58 surgery cases of senile hypopharyngeal cancer patients more than 65 years old were colleted and analyzed. Thirty-one cases preserved the laryngeal function, while the rest did not. Perfect preoperative preparation was done before surgery. Surgical resection specimens were sent to frozen-section examination. When the negative incisal margin was confirmed, the defect was repaired by the appilication of local stitching, ribbon muscle flap, major myocutaneous flaps, split thickness skin and replacement of esophagus by stomach. Radical radiotherapy was used after surgery. Survival rate was calculated by the Kaplan-Meier method. Chi-square test was used to compare complications of the two groups. RESULT: The 3 years and 5 years survival rate for all cases were 48.3% (28/58) and 27.6% (16/58), respectively. For patients with laryngeal function preservation, the 3 years and 5 years survival rate were 51.6% (16/31), 29.0% (9/31), respectively. For cases without laryngeal function preservation, the 3 years survival rate and 5 years survival rate were 44.4% (12/ 27), 25.9% (7/27), respectively. The result showed no obvious difference in survival rate between two groups (P > 0.05). Surgery complication rate were 45.2% (14/31) and 40.7% (11/27), without obvious differences between the two groups (P > 0.05). CONCLUSION It is feasible for senile hypopharyngeal cancer patients to choose suitable operation based on their physical conditions and the tumor extension. The key issues include well perioperative treatment management, correct indications grasp, and intraoperative repair skills improvement.
Aged ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; Survival Rate

Humans ; Hypopharyngeal Neoplasms ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps

Carcinoma ; Fistula ; Humans ; Hypopharyngeal Neoplasms/surgery* ; Hypopharynx ; Pharyngeal Diseases

Humans ; Plummer-Vinson Syndrome/drug therapy* ; Carcinoma ; Hypopharyngeal Neoplasms/surgery*

Carcinoma, Squamous Cell ; surgery ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Larynx ; physiology ; surgery

Carcinoma, Squamous Cell ; surgery ; Head and Neck Neoplasms ; surgery ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; surgery

OBJECTIVETo evaluate the application of acellular dermal matrix (ADM) in the reconstruction of defect after head and neck tumor resection.

METHODSA total of 75 cases applied with ADM after head and neck tumor resection were reviewed. There were 47 cases of laryngeal carcinoma (glottic 41, supraglottic 3, and infraglottic 3), 5 cases of hypopharyngeal carcinoma, 11 cases of maxillary sinus carcinoma, 9 cases of oral cavity tumor, 3 cases of cervical trachea tumor. Among them 25 cases of laryngeal carcinoma, 4 cases of hypopharyngeal carcinoma, 7 cases maxillary carcinoma, 6 cases oral carcinoma, and one case of cervical trachea malignancy received postoperative adjuvant chemoradiotherapy. The patients were postoperatively followed up from 2 weeks to 3 years.

RESULTSAmong 75 cases, 65 cases, including 40 cases of laryngeal carcinoma, 4 cases of hypopharyngeal carcinoma, 9 cases of oral cavity tumor, 9 cases of maxillary carcinoma and 3 cases trachea tumor, presented with good wound healing without any complication within 3 months; the 47 patients with tracheotomy were decannulated successfully; 2 cases of laryngeal carcinoma and 1 case of hypopharyngeal carcinoma were complicated with pharyngeal fistula, which healed with dressing change, followed by decannulation; 5 cases had laryngeal stenosis and decannulation failed in these patients; and 3 cases of maxillary carcinoma had wound infection.

CONCLUSIONADM application is a easy and feasible method for the repair of the defect after head and neck tumor resection.

Aged ; Anastomosis, Surgical ; Esophageal Neoplasms ; surgery ; Female ; Gastroplasty ; methods ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Male ; Middle Aged

Adult ; Carcinoma, Squamous Cell ; surgery ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Male ; Middle Aged

In order to evaluate the availability of the lateral horizontal laryngectomy and anaplasty of epiglottis to treat some patients with specific supraglottic carcinomas and hypopharyngeal carcinomas, 17 cases of laryngeal and hypopharyngeal carcinomas were retrospectively analyzed, whose tumors were located at the lateral margin of epiglottis, aryepiglottic fold, medial wall of piriform fossa and were treated by the lateral horizontal laryngectomy and anaplasty of epiglottis. The results showed that all cases took food by mouth in postoperative 9-14 days and subjected to decannulation in postoperative 9-15 days. Three cases had postoperative hoarse voice. The free-disease survival rate of 3 years was 71.4% in 14 cases followed up after the first surgical therapy, and the overall free-disease survival rate of 3 years was 85.7% after the second surgical therapy. It was concluded that the manipulations of the lateral horizontal laryngectomy and epiglottiplasty were simple. It could alleviate the postoperative symptoms of aspiration and bucking remarkably and shorten their postoperative recovery time, yet does not lower the survival rate of patients if laryngocarcinoma or hypopharyngeal carcinoma cases were properly selected.
Carcinoma, Squamous Cell/*surgery ; Epiglottis/*surgery ; Hypopharyngeal Neoplasms/surgery ; Laryngeal Neoplasms/*surgery ; Laryngectomy/*methods ; Otorhinolaryngologic Surgical Procedures/methods