Cancers of the upper aerodigestive tract (UADT) constitute 3.5-4% of all malignancies. Since the majority of cases are squamous cell carcinomas which are related with epidemiologic factors, a different pattern of UADT cancer might be present between the Western and Asian populations. We performed a pathology based statistical study on UADT cancers in Korean patients. Cases from Korea Cancer Center Hospital, from January 1, 1988 through December 31, 1998, were subjected to the study. Among 2,842 cases, epithelial malignancies accounted for 87.8%, with squamous cell carcinoma as the major type (76.5%). The larynx was the most commonly affected site (26%), followed by the oral cavity (25.1%), oropharynx (13%), nasopharynx (9%), hypopharynx (8.4%), paranasal sinuses (6.4%), nasal cavity (6%) and salivary glands (6.1%). The percentage of squamous cell carcinoma was highest (98.7%) at the hypopharynx, and lowest at the nasal cavity (42.3%), which showed the most diverse tumor entities. Korean patients with UADT cancers presented with a higher incidence of non-epidermoid malignancy including sarcoma (1.5%) and malignant melanoma (1.4%), and a higher frequency of involvement of the sinonasal tract, compared with the Western patients.
Head and Neck Neoplasms/classification/*pathology ; Humans ; Hypopharyngeal Neoplasms/classification/pathology ; Korea ; Laryngeal Neoplasms/classification/pathology ; Mouth Neoplasms/classification/pathology ; Nasal Cavity ; Nasopharyngeal Neoplasms/classification/pathology ; Oropharyngeal Neoplasms/classification/pathology ; Paranasal Sinus Neoplasms/classification/pathology ; Salivary Gland Neoplasms/classification/pathology

Adolescent ; Angiofibroma ; surgery ; Endoscopy ; Humans ; Male ; Nasopharyngeal Neoplasms ; surgery ; Nose ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods

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

Adult ; Endoscopy ; Female ; Humans ; Maxillary Sinus ; Neurilemmoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; surgery ; Temporal Bone ; innervation

OBJECTIVE: To investigate the relative factors of pharyngo cutaneou fistulas after larynx cancer and lower pharynx cancer surgery. METHOD: The clinical datas of 87 larynx cancer patients and lower pharynx cancer patients admitted were retrospectively analyzed. According to the type of postoperative complications all cases could be divided into pharyngo cutaneou fistulas group and no pharyngo cutaneou fistulas group. Thirty-eight kinds of factors,including age, clinical stage, plasma electrolytes level and type of procedure are in the multivariate analysis, and the variability indicators are in binary-regression analysis. RESULT: Eleven patients had pharyngo cutaneou fistulas (12.64%). Univariate analysis indicated that BMI, pre-operative serum potassium, operation time, cervical lymph dissection, post-operative prealbumin, post-operative hemoglobin, infection and delayed union of incision were the risk factors of pharyngo cutaneou fistulas (P < 0.05). Logistic stepwise regression analysis indicated that post-operative prealbumin and operation time were the independent risk factors. CONCLUSION To avoid pharyngo cutaneou fistulam, it is very necessary to correct electrolyte disorder and negative nitrogen balance. To shorten the operation time, to avoid incision infection and delayed union were helpfulness, too.
Cutaneous Fistula ; pathology ; Digestive System Fistula ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Multivariate Analysis ; Otorhinolaryngologic Surgical Procedures ; Pharyngeal Neoplasms ; surgery ; Pharynx ; pathology ; surgery ; Postoperative Complications ; Retrospective Studies

Combined Modality Therapy ; Head and Neck Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Humans ; Hypopharyngeal Neoplasms ; radiotherapy ; surgery ; Medical Oncology ; education ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Neoplasm Staging ; Otorhinolaryngologic Surgical Procedures ; education

OBJECTIVETo investigate the surgical approaches for sinonasal tumors with intracranial extension.

METHODSSeventeen patients with intracranial invasion tumors were treated surgically by maxillectomy combined with frontal or infratemporal approaches in 11 cases, including squamous cell carcinoma 8 cases, papillocarcinoma 2 cases and meningioma 1 case. Nasofrontal bone translocation in 1 case which was a meningioma case, craniofacial approaches in 5 cases, including squamous cell carcinoma 4 cases and esthesioneuroblastoma 1 csae.

RESULTSOne of two meningioma cases with cavernous sinus invasion was incompletely resected, another case was resected en bloc. In malignant group, ten cases were treated by nasomaxillectomy combined with frontal or infratemporal approaches. One patient died 1 year after operation, 7 cases survived for over 3 years, and 5 for over 5 years. Five cases were treated by craniofacial approach, among them, one patient died 6 months after operation, 4 cases survived for over 3 years, and 2 for over 5 years. All patients healed smoothly.

CONCLUSIONSMaxillary nasopyramid translocation combined with frontocranial or infratemporal approach is available for en bloc removal of sinonasal tumors with intracranial extension. The nasofrontal bone translocation is available for removal of tumors with limited intracranial extension and well developed frontal sinus. Cranioanterolateral facial approach is suitable for nasocranial tumors with facial bone involvement.

Brain Neoplasms ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; pathology ; surgery

OBJECTIVETo compare endoscopic approach with lateral rhinotomy for treatment of the sinonasal inverted papilloma in terms of advantage, indications and limitations of the procedures.

METHODSEighty-six cases with inverted papilloma were reviewed retrospectively, among which 23 cases underwent transnasal endoscopic procedures including 10 combined with Caldwell-Luc intervention, and 63 cases underwent lateral rhinotomy. The follow-up period ranged from 11 - 36 m (mean 23 m). The data were processed statistically by SPSS 10.0 software.

RESULTBoth procedures permitted removal of most sinonasal inverted papilloma. The endoscopic surgery provided an excellent visualization, and preserved a vital anatomic structure and left no facial scar. Lateral rhinotomy was associated with postoperative facial scar or deformity. The recurrence rate in lateral rhinotomy group was 9.5% and in endoscopic approach was 13% (P >0.05).

CONCLUSIONEndoscopic approach is favored for the treatment of non-massively extending sinonasal inverted papilloma because of an acceptable recurrence and a better cosmetic results.

Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Nose Neoplasms ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome

Adolescent ; Endoscopy ; Ethmoid Sinus ; Frontal Sinus ; surgery ; Humans ; Male ; Osteoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; surgery

OBJECTIVETo investigate the value of narrow band imaging (NBI) endoscopy in the detection of unknown primary tumor site with cervical lymph node metastases of squamous cell carcinoma.

METHODSFifty-three patients with cervical lymph node metastases of squamous cell carcinoma treated in our department between June 2009 and December 2011 were enrolled in this study. Their primary tumor site was not detected by routine computed tomography, magnetic resonance imaging and laryngoscopy. The nasopharyngolarynx was examined by NBI endoscopy to explore the primary tumor site.

RESULTSA total of 53 cases with cervical lymph node metastasis of squamous cell carcinoma from an unknown primary were examined under NBI endoscopy. The primary tumor site was confirmed by NBI examination in 47.2% (25/53) of patients, significantly better than routine radiology and endoscopy (0, P < 0.001). These primary tumors were small and superficial, with characteristic mucosal vascular morphologies. The superficial nasopharyngeal carcinomas under NBI examination showed the superficial thin branch-like or torturous line microvessels. The notable characteristics of the squamous cell carcinoma of oropharynx, hypopharynx and larynx was the well demarcated brownish area and scattered brown dots.

CONCLUSIONThe NBI endoscopy can provide better visualization of the morphology of superficial mucosal vasculature and improve the ability to detect possible primary cancer in patients with primary unknown cervical lymph node metastasis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Carcinoma in Situ ; diagnosis ; therapy ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; therapy ; Female ; Follow-Up Studies ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; therapy ; Laryngeal Neoplasms ; diagnosis ; therapy ; Lymphatic Metastasis ; Male ; Middle Aged ; Narrow Band Imaging ; methods ; Nasopharyngeal Neoplasms ; diagnosis ; therapy ; Neoplasms, Unknown Primary ; diagnosis ; therapy ; Oropharyngeal Neoplasms ; diagnosis ; therapy