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

Free jejunum has always been a good choice for circumferential hypopharynx and cervical esophagus reconstruction with a low complication rate. Although more and more flaps were used in recent years, free jejunum is still considered as the first choice for such defect.
Esophagoplasty ; Esophagus ; surgery ; Humans ; Hypopharynx ; surgery ; Jejunum ; surgery ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps

Because of minimal donor site morbidity, adequate tissue, excellent clinical and functional results, the anterolateral thigh flap has become one of the most important tissue flaps which are used to repair the defects of head and neck. Generally, anterolateral thigh flap is mainly used to repair the maxillofacial defects in head and neck surgery. However, the anterolateral thigh flap is a better tissue flap for reconstruction of hypopharyngeal and cervical esophageal defects.
Esophagus ; surgery ; Head ; surgery ; Humans ; Hypopharynx ; surgery ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thigh

OBJECTIVETo study the short-term results and technological improvement of free anterolateral thigh (ALT) flaps in the reconstruction of circumferential hypopharyngeal defects.

METHODSThe free ALT flap with a reporter skin paddle was used in 22 cases with circumferential hypopharyngeal defects. The short-term results of reconstructive surgeries and key points, advantages and complications of this technique were summarized.

RESULTSThe length of circumferential hypopharyngeal defects ranged from 7 to 9 cm. ALT flap with an area of (8-9) cm × (11-18) cm was harvested. A reporter skin island with the skin area of (2.0-3.0) cm × (2.5-4.0) cm was designed. 91% (20/22) of ALT flaps survived. Two cases with flap necrosis underwent second reconstruction with a pedicled pectoralis major flap. All the patients had patent anastomotic lumen. Good postoperative subjective swallowing evaluation was obtained in 59% (13/22) of patients; 41% (9/22) of patients had acceptable swallowing results. Three patients (14%) presented with postoperative pharyngocutaneous fistula. One case recovered spontaneously in short-term and other two cases received the second reconstructive surgery.

CONCLUSIONSThe application of free ALT flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defect is technologically easy and reliable, with satisfying swallowing function and limited trauma.

Free Tissue Flaps ; Humans ; Hypopharynx ; pathology ; surgery ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Thigh

Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.
Humans ; Hypopharynx/surgery* ; Pharynx/surgery* ; Endoscopes ; Surgical Instruments ; Foreign Bodies/diagnosis*

Fibrovascular polyp of the hypopharynx and esophagus, a rare, benign, intraluminal and submucosal tumor, is most commonly originated from the proximal esophagus. We discussed four cases with regurgitation, respiratory symptom or the feeling of a mass in the throat. All the patients were examined with laryngoscope under general anesthesia. A transverse cervical incision was performed in one patient and the polyps were excised under laryngoscope with CO2 laser in the other three patients. All the lesions were removed successfully. Diagnostic and therapeutic principles involved in these cases are presented and discussed. The recognition of fibrovascular polyp of the hypopharynx and esophagus as a potential cause of regurgitation is paramount. Surgical excision is recommended because of the satisfactory outcome.
Adult ; Aged ; Aged, 80 and over ; Esophageal Diseases ; surgery ; Female ; Humans ; Hypopharynx ; Male ; Middle Aged ; Pharyngeal Diseases ; surgery ; Polyps ; surgery

BACKGROUND: The purpose of this retrospective study was to develop a two- and three-dimensional analysis of the airway using cone-beam computed tomography (CBCT) and to determine whether the airway space would be changed in mandibular prognathism after bimaxillary surgery involving maxillary posterior impaction. METHODS: Patients requiring orthognathic surgery from 2012 to 2014 were recruited for this study. CBCT scans were obtained at three points: preoperatively (T0), immediate postoperatively (T1), and after 6 months postoperatively (T2). The nasopharynx, oropharynx, and hypopharynx were measured on the CBCT scan for each patient in a repeatable manner. With the midsagittal plane, linear measurements in the middle of each were obtained. For the CBCT, volumetric measurements of each and total airway were obtained. RESULTS: A total of 22 consecutive patients (11 men and 11 women) were included in the present study. The total volume was significantly reduced (p < .001). However, the change of the diameter and volume of the nasopharynx was not statistically significant (p = .160, p = .137, respectively). In the oropharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p < .001, p = .001, respectively) and also preoperatively and after 6 months postoperatively (p = .001, p = .010, respectively). In the hypopharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p = .001, p < .001, respectively) and also preoperatively and after 6 months postoperatively (p = .001, p < .001, respectively). CONCLUSIONS: The bimaxillary surgery involving maxillary posterior impaction can reduce the volume of airway in the patients of mandibular prognathism. Although total airway volume was reduced significantly, the changes in the volume and diameter of the nasopharynx were not statistically significant. The maxillary posterior impaction affects on the nasopharyngeal airway minimally.
Airway Management ; Cone-Beam Computed Tomography ; Humans ; Hypopharynx ; Male ; Nasopharynx ; Oropharynx ; Orthognathic Surgery ; Prognathism* ; Retrospective Studies

OBJECTIVETo explore the substantial resection limits of CO2 laser surgery for hypopharynx and the course of wound healing in animals, for the purpose of evaluating the clinic usefulness of transoral CO2 laser surgery in the treatment of selected hypopharyngeal carcinomas.

METHODSTwenty-three dogs were randomly assigned to two groups. Group one (11 dogs) received left piriform sinus resection, group two (12 dogs) received the resection of posterior wall of the hypopharynx. Six dogs in group one were killed immediately or 4, 8, 12, 16, 20 d post-operatively. Seven dogs in group two were killed immediately or 7, 14, 21, 28, 35, 42 d post-operatively. The whole larynx and hypopharynx were taken out and the specimens were examined by naked eyes and under microscope. The other 5 dogs in each group were fed until the wound healed, the duration were observed.

RESULTSAll the operations were successful and the results were satisfactory. In group one, the dogs could take food the day after operation; two dogs had slight cough during eating and recovered after five days. In group two, the dogs could take food the next day after operation, eight dogs had slight cough during eating and recovered after ten days. The excision dimension was satisfactory. In group one (resection of the lateral wall of piriform sinus), the size of raw surface was (7.5 +/- 0.8) cm2 (x +/- s) and the healing time was (18.4 +/- 1.5) d. In group two (resection of the posterior wall of the hypopharynx), the wound surface was (7.0 +/- 0.5) cm2 and the healing time was (39.8 +/- 1.9) d. The healing time in group two was significantly longer than that in group one (t = 19.535, P <0. 01). The post-operative healing process were observed, including cellulose membrane coverage, granulation filling and epithelization.

CONCLUSIONSTransoral CO2 laser was suitable for partial hypopharynx resection. Animals can recuperate well with little complications. Although the course of wound healing was delayed, wound surface can recover with good laryngeal and deglutition functions.

Animals ; Dogs ; Endoscopy ; Hypopharynx ; surgery ; Laser Therapy ; Lasers, Gas ; Pharyngectomy ; methods

OBJECTIVE: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. METHODS: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. RESULTS: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. CONCLUSIONS: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.
Adult ; Cone-Beam Computed Tomography ; Humans ; Hypopharynx ; Male ; Malocclusion ; Nasopharynx ; Oropharynx ; Orthognathic Surgery

Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.
Humans ; Hypopharynx/diagnostic imaging* ; Valsalva Maneuver ; Hypopharyngeal Neoplasms/surgery* ; Tomography, X-Ray Computed ; Carcinoma