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

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

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

OBJECTIVETo study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma.

METHODSA retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage I, n = 6; stage II, n = 12; stage III, n = 82; stage IV, n = 205), the sites of origin were pyriform sinus (n = 234), postcricoid (n = 21), posterior pharyngeal wall (n = 35) and superior hypopharynx (n = 15). Of the 305 patients, 206 (67.54%, stage I, n = 6; stage II, n = 12; stage III, n = 65; stage IV, n = 123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage III, n = 17; stage IV, n = 82) had no laryngeal function preserved. All had 55-75 Gy radiotherapy according to their need.

RESULTSA total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage I), 71% (stage II), 58% (stage III), and 36% (stage IV). The 5-year survival of the laryngeal function preserved group was 48% (n = 66), the rate of complications 28% (n = 58) and the rate of residual tumor 5.8% (n = 12), compared with the no laryngeal function preserved group 37% (n = 20), 31.3% (n = 31), and 6% (n = 6) (P > 0.05).

CONCLUSIONOnly a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.

Adolescent ; Adult ; Aged ; Female ; Humans ; Hypopharyngeal Neoplasms ; mortality ; physiopathology ; surgery ; Hypopharynx ; surgery ; Larynx ; physiopathology ; Male ; Middle Aged ; Survival Rate

OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix (ADM) on the repair of different tissue defects in pharyngeal and laryngeal cancer. METHOD: Twenty-three cases of pharyngeal and laryngeal cancer were analyzed retrospectively, including 16 patients with pharyngeal cancer, and 7 patients with laryngeal cancer. After surgery, the patients appeared two types of tissue defects respectively: hypopharynx tissue defect and neck skin tissue defect. These defects were repaired with ADM, and the clinical effects were observed. RESULT: Sixteen cases of hypopharynx tissue defect and 7 cases of neck skin tissue defect were repaired with ADM. One case in hypopharynx tissue defect group and 2 cases in neck skin tissue defect group undergone pharyngeal fistula postoperatively. CONCLUSION The repair of tissue defects in pharyngeal and laryngeal cancer with ADM had some advantages, such as good histocompatibility, low immune rejection, wide material sources and simple method. There were some differences in clinical effects between hypopharynx cavity defect and neck skin tissue defects, so the emphasis of the need to pay attention to is different in the clinical.
Acellular Dermis ; Dermatologic Surgical Procedures ; Humans ; Hypopharynx ; surgery ; Laryngeal Neoplasms ; surgery ; Mucous Membrane ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Retrospective Studies