Abscess ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; Pharyngeal Diseases ; diagnosis

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

The patient complained of recurrent sore throat for 2 years, who was diagnosed parapharyngeal abscess or tonsillitis for four times during June 16, 2012 to April 16, 2013. Special physical examination: left or right lateral pharyngeal wall is slightly elevated. Routine blood test showed increasing white blood cells and neutrophils. Oropharyngeal CT showed right lateral pharyngeal wall swelling and abscess formation? Repeated puncture showed no obvious purulent secretions. Symptoms were improved after anti-inflammatory treatment, but it recurrently happened later. Bilateral tonsillectomy was performed under general anesthesia on April 29, 2013. Pathological report (May 6, 2013) showed: (left) chronic tonsillitis with lymphoid hyperplasia; chronic inflammation in (right) tonsil tissue, and salivary gland tissue is also observed, considering as the hyperplasia of ectopic salivary gland tissue and interstitial lymphocytic oinfiltration.
Anesthesia, General ; Choristoma ; pathology ; Chronic Disease ; Humans ; Hyperplasia ; pathology ; Pharyngeal Diseases ; pathology ; Pharyngitis ; etiology ; Recurrence ; Salivary Glands ; Tonsillectomy ; Tonsillitis ; pathology

OBJECTIVETo evaluate the transhyoid resection of oropharyngeal anterior wall cancer and oncological outcomes of the surgery combined with radiotherapy.

METHODSA total of 24 cases with carcinoma located in the anterior wall of oropharynx was reviewed. The TNM stages were as follows: T2 in 7 cases, T3 in 2 cases, T4 in 15 cases; NO in 7 cases, N1 in 4 cases, N2 in 12 cases and N3 in 1 case. Tumor resection was performed via transhyoid approach, including 9 cases with partial glossectomy + partial laryngectomy, 7 cases with partial glossectomy + total laryngectomy, 7 cases with total glossectomy + partial laryngectomy and 1 case with partial glossectomy alone pectoralis major myocutaneous flaps were applied to repair synchronously the defects of tongue and lateral pharyngeal wall in 16 cases and the defect of cervical skin in 1 case. Radial forearm free flap and sternohyoid myocutaneous flap were used to repair the defect of tongue and lateral and posterior pharyngeal wall in 1 case. Sternohyoid myocutaneous flap was applied to reconstruct the tongue base in 2 cases. Bilateral and unilateral neck dissections were performed in 20 cases and 4 cases respectively. Five cases received preoperative radiotherapy and 16 cases received postoperative radiotherapy.

RESULTSAll cases had negative surgical margin. Pathological examination showed neck lymph metastasis in 17 cases (70.8%). Three patients had postoperative pharyngocutaneous fistula. Two of them who underwent partial glossectomy + total laryngectomy and pectoralis major myocutaneous flaps synchronously reconstruction suffered from pharyngocutaneous fistula 4 days after operation. The fistula was closed by re-suturation following debridement and 2 weeks dressing change. The other one who underwent partial glossectomy + partial laryngectomy suffered from pharyngocutaneous fistula during postoperation radiotherapy and healed by the pectoralis major myocutaneous repair. Tracheostomy tubes were removed within 1-6 months, with good voice and swallowing functions, in 16 of 17 cases who underwent partial laryngectomy. Another one failed to pull out tracheotomy tube because of dyspnea. Twenty one cases were followed up over 3 years and Kaplan-Meier survival analysis showed the 3-year overall survival rate was 72.6%.

CONCLUSIONSThe transhyoid tumor resection is an effective surgical approach for oropharyngeal anterior wall cancer. The defect following tumor resection is commonly need repair synchronously with various flaps. Acceptable outcome could be received by surgery combined with radiotherapy.

Carcinoma ; Cutaneous Fistula ; Fistula ; Glossectomy ; Humans ; Laryngectomy ; Larynx ; Neck Dissection ; Oropharyngeal Neoplasms ; radiotherapy ; surgery ; Pectoralis Muscles ; Pharyngeal Diseases ; Pharynx ; Reconstructive Surgical Procedures ; Surgical Flaps ; Survival Rate ; Tracheostomy

This paper reports a case of recurrence of tonsillar cancer on the right 6 months after radiotherapy with pharyngeal hemorrhage for 4 days and aggravation in the next day. The pharyngeal hemorrhage was severe in the case and the maximum of single amount of bleeding was approximately 200 ml. The examination showed active bleeding on the ulcer with a diameter of 2 cm in the right tonsil and the depth of 1 cm. After repeated compression hemostasis proved to be invalid, selective embolization was applied on the patient and the symtoms of pharyngeal hemorrhage disappeared without complications. The patient was discharged after 2 weeks of observation without any recurrence of hemorrhage.
Embolization, Therapeutic ; methods ; Hemorrhage ; etiology ; therapy ; Hemostasis ; Humans ; Neoplasm Recurrence, Local ; Palatine Tonsil ; Pharyngeal Diseases ; etiology ; therapy ; Recurrence ; Tonsillar Neoplasms ; complications

A comparison study was carried out on 1,242 medical records of pharyngolaryngeal disease among pediatric inpatients with ages of 1 -15 in Hue Central Hospital and 2852 medical records of pharyngolaryngeal diseases among pediatric inpatients with the same ages in Aue hospital, West Germany. Results showed that the pharyngolaryngeal diseases were leading diseases among diseases of ear, nose and pharynx in both hospitals. The rate of these diseases treated by operation in Aue hospital was higher than this in Hue hospital. There was difference of the morbidity rate between age groups. The rate of treatment of infection disease and infections complication in Hue hospital was higher than this in Aue hospital. The Aue hospital considered in prophylactic operation, diagnosis and rehabitation better than Hue hospital. There was no death in Aue hospital while there were 6 deaths in Hue hospital.
Laryngeal Diseases ; Pharyngeal Diseases ; Child

Adult ; Female ; Humans ; Laryngeal Diseases ; microbiology ; Male ; Middle Aged ; Pharyngeal Diseases ; microbiology ; Pharyngitis ; microbiology ; Syphilis ; Treponema pallidum

Humans ; Pyriform Sinus/surgery* ; Thyroid Neoplasms/diagnosis* ; Fistula/surgery* ; Diagnostic Errors ; Pharyngeal Diseases/surgery*

Congresses as Topic ; Laryngeal Diseases ; Pharyngeal Diseases

Autoimmune Diseases ; Humans ; Pharyngeal Diseases ; Ulcer