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

Objective: To explore the surgical methods and effects of transoral endoscopic resection of benign tumors in parapharyngeal space via medial pterygomandibular raphe approach. Methods: The clinical data of 23 patients who underwent resection of benign tumors in parapharyngeal space by endoscopic medial pterygomandibular raphe approach from January 2016 to July 2020 in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University were analyzed retrospectively. There were 14 males and 9 females with a median age of 43 years. The tumors were located in the anterior space of the styloid process in 13 cases and in the posterior space in 10 cases. The smallest tumor volume was 7.3 ml and the largest was 80.2 ml. The preoperative imaging features, the characteristics and risks of this approach in the operation were analyzed, and the feasible mode of operation was explored. Results: All patients completed the operation successfully. The intraoperative blood loss was 20 to 50 ml, with an average of 28.3 ml. The operation time was 40 to 110 min, with an average of 75.4 min. The incision length was 2 to 4 cm, with an average of 3.0 cm. The postoperative pain score was 2 to 4, with an average of 3.2. The postoperative hospital stay was 4 to 9 d, with an average of 6.7 d. Postoperative pathological diagnosis included pleomorphic adenoma (n=12), neurilemmoma (n=10) and basal cell adenoma (n=1). The patients were followed up for 6 to 60 months. There was no postoperative complication such as infection or serious bleeding, and there was no tumor recurrence after operation. Conclusion: Endoscopic resection of benign tumor in parapharyngeal space via medial pterygomandibular raphe approach is a safe, effective, and minimally invasive surgical method for the treatment of tumors in parapharyngeal space.
Adult ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; Parapharyngeal Space ; Pharyngeal Neoplasms/surgery* ; Pharynx ; Retrospective Studies

Objective: To explore the feasibility and perioperative safety of transoral robotic surgery with da Vinci Xi platform for pharyngolaryngeal tumors. Methods: A retrospective analysis was performed on 55 consecutive cases with resection of pharyngolaryngeal tumors by transoral robotic surgery with da Vinci Xi platform from July 27, 2020 to October 31, 2021 in the Department of Head and Neck Surgery, Fudan University Eye, Ear, Nose and Throat Hospital, including 44 males and 11 females, aged 25-79 years. There were 41 cases of oropharyngeal tumors, 9 cases of parapharyngeal space tumors, 2 cases of laryngeal tumors, 2 cases of hypopharyngeal tumors and 1 case of retropharyngeal space tumor. Operative time, intraoperative blood loss, postoperative hospital stay, perioperative tracheotomy, nasal feeding, hemorrhage and other complications were analyzed. Results: Of the 55 patients, 54 received resection of pharyngolaryngeal tumors by da Vinci robot through oral approach, and only 1 case of pyriform sinus carcinoma underwent a conversion to open surgery due to poor exposure of lower margin. The average surgical time for the patients with transoral robotic surgeries was 64.4 min, the average blood loss was 24.8 ml, the average postoperative hospital stay was 6.9 d, and the average oral feeding time was 11.1 d. Seventeen patients (30.9%) underwent preventive tracheotomy during surgery. Among 38 cases of laryngeal cancer, 28 underwent simultaneously neck dissection. No serious complications occurred in all patients during and after operation. The follow-up time was 1-15 months. Aside from 1 patient had a relapse 10 months after surgery, other patients had no recurrence or metastasis. Conclusion: Transoral robotic surgery with da Vinci Xi is safe, effective and minimally invasive for resection of pharyngolaryngeal tumors under reasonable indications.
Adult ; Aged ; Feasibility Studies ; Female ; Humans ; Laryngeal Neoplasms/surgery* ; Male ; Middle Aged ; Pharyngeal Neoplasms/surgery* ; Retrospective Studies ; Robotic Surgical Procedures/methods*

Humans ; Pharyngeal Neoplasms ; Esophageal Neoplasms/surgery*

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

Child ; Choristoma ; pathology ; surgery ; Ear, Middle ; pathology ; surgery ; Female ; Hamartoma ; pathology ; surgery ; Humans ; Pharyngeal Neoplasms ; pathology ; surgery ; Salivary Glands ; pathology ; surgery

To explore the diagnosis,treatment,surgical approach and prognosis of parapharyngeal space tumors.The clinical data of 188 patients with parapharyngeal space tumor who were treated from January 2007 to December 2016 were analyzed retrospectively.All patients underwent imaging examination before operation.Surgical approach was as follows:transcervical approach applied in 159 cases,endoscopic-assisted transnasal approach in 9 cases,transcervical-transmandibular approach in 8 cases,transcervical-transparotid approach in 8 cases,transoral approach in 7 cases,and infratemporal fossa approach in 4 case.Of the 188 cases,the tumor was benign in nature in 168 cases(89%)and malignant in 20 cases(11%).Complications occurred in 28(15%)patients,with the most common symptom being hoarseness.168 cases of benign tumors were followed up for 10 months to 10 years,and 3 cases were lost and 4 cases had recurrence.All cases underwent re-operation.Patients with malignant tumors received combined treatment after surgery,and 3 cases were lost to follow-up,1 case died of recurrence 9 months after surgery,the rest survived.Surgery is the preferred method for treating parapharyngeal space tumors and postoperative recurrence rate is pretty low.Endoscopy provides a new surgical management method,helping to reduce postoperative complications and recurrence rate.
Endoscopy ; Humans ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; complications ; diagnosis ; surgery ; Retrospective Studies

OBJECTIVE: To investigate the application value of narrow band imaging (NBI) in early diagnosis of pharyngolaryngeal tumors. METHOD: A total of 106 patients received NBI endoscopy in the endoscopic diagnosis. Lesions found under the white-light endoscopy mode and NBI endoscopy mode were compared in the morphology of capillaries on lesiorn surface and the clarity of lesion rim. Biopsy was performed in suspected areas with those two endoscopies for the lesions found under white-light endoscopy and NBI endoscopy, the morphology of capillaries on the surface of lesion and the clarity of lesion boundary were compared between both. Biopsy was performed for suspected areas under two modes, and specimens were preserved in 10% formaldehyde for pathological examination. The characteristic, position and endoscopic diagnosis under two modes were recorded. All the patients underwent corresponding laryngeal tumor resection according to the histopathological result of biopsy, and the histopathological result of resected tissues was taken as the gold standard for diagnosis. The biopsy detection rate and biopsy correct detection rate of malignant lesions in two groups were calculated and statistical compared. RESULT: The diagnostic accuracy under white-light mode was 75.47%, while that under NBI mode was 96.23%, and the difference between them was statistically significant (χ² = 18.375, P < 0.01). The biopsy correct detection rate under white-light mode was 82.08%, while that under NBI mode was 95.28%, and the difference between them was statistically significant (χ² = 12.071, P < 0.01). The correct detection rate of malignant tumor under white-light mode was 48.15%, while that under NBI mode was 92.59%, and the difference between them was statistically significant (χ² = 10.083, P < 0.01). CONCLUSION Using NBI endoscopy to observe the morphological changes of capillaries on the pharyngolaryneal mucosa surface can increase the detection rate of early pharyngolaryngeal tumors, so it is worth to be widely applied.
Biopsy ; Early Detection of Cancer ; Endoscopy ; Humans ; Laryngeal Neoplasms ; diagnosis ; surgery ; Larynx ; surgery ; Narrow Band Imaging ; Pharyngeal Neoplasms ; diagnosis ; surgery

OBJECTIVE: To explore the clinical effects and short-term complications of using free jejunum graft (FJG) to reconstruct the defects by resections of pharyngeal, laryngeal or cervical esophageal cancers. METHOD: Fifty-eight cases of pharyngeal, laryngeal or cervical esophageal cancers were reconstructed with FJG. All cases were analyzed retrospectively. RESULT: The success rate of FJG transplantations was 91.4% (53/58). The incidence of post-operative short-term complication was 43.1% (25/58), which was not related to age or BMI. The most common complication was anastomotic leakage (18.9%), which was not related to per-operative radiation therapy. However, BMI > 25 cases had significantly higher incidence of anastomotic leakage than BMI ≤ 25 cases (P = 0.009). The second and third most common complications were respiratory system complications (10. 3%) and FJG necrosis (8. 6%). Para-operative death rate was 3.4% (2/58). Two-year overall survival rates of hypopharyngeal cancer and cervical esophageal cancer were 49% and 67% respectively. The group with no short-term complications had a slightly better survival rate than the group with short-term complications from the Kaplan-Meier curve, but there was no significant difference (P = 0.103). CONCLUSION FJG is ideal to reconstruct cervical digestive tract circumferential defects with a high success rate and a low mortality. However, the post-operative complication rate is high. Intensive observation, early detection and timely treatment of complications are crucial.
Esophageal Neoplasms ; surgery ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Jejunum ; transplantation ; Laryngeal Neoplasms ; surgery ; Pharyngeal Neoplasms ; surgery ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Survival Rate

OBJECTIVE: To evaluate the effect and feasibility of coblation treatment for laryngopharynx hemangioma. METHOD: Retrospectively analyzed 24 cases with coblation treatment for laryngopharynx hemangioma in recent years. RESULT: Twenty-four patients were treated with coblation, follow-ups range 6 months to 24 months after surgry. Recurrence occurred in 2 months after surgry in one patient who was cured with coblation for second time. There was incomplete vocal cord paralysis in another patient because of wide range angeioma. CONCLUSION Coblation treatment for laryngopharynx hemangioma was an ideal way to less bleeding, less damage and more clearfield of vision.
Catheter Ablation ; Hemangioma ; surgery ; Humans ; Hypopharynx ; pathology ; surgery ; Laryngeal Neoplasms ; surgery ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; surgery ; Retrospective Studies ; Vocal Cord Paralysis