Humans ; Pharyngeal Neoplasms ; Esophageal Neoplasms/surgery*

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

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

Humans ; Jaw Neoplasms ; pathology ; surgery ; Mouth Neoplasms ; pathology ; surgery ; Pharyngeal Neoplasms ; pathology ; surgery ; Skull Base ; pathology ; surgery

Abdominal Neoplasms ; pathology ; surgery ; Dendritic Cells, Follicular ; pathology ; Humans ; Male ; Middle Aged ; Pharyngeal Neoplasms ; pathology ; surgery ; Sarcoma ; pathology ; surgery

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 learn the anatomical structure of the parapharyngeal space and to analyze the pathological type, preoperative evaluation and choice of surgical approach of parapharyngeal space tumors. METHOD: To conduct a retrospective analysis of the clinical data of 43 patients who receive surgery in our department from March 2002 to January 2011. All patients undergo enhanced CT and MRI before surgery and enhanced CT reconstruction was also adopted in the cases after the year 2009. All 43 cases of surgeries were performed under general anesthesia. Of all the cases, the lateral neck path were chosen for 38 cases, lateral neck parotid path for 3 and lateral neck path combined with mandibular split operation for 2, 1 of which tracheotomy was conducted. Suction drainage was placed in the surgical cavity of all cases. And patients without contraindications were treated with glucocorticoids. RESULT: In 42 of all 43 cases, the tumor was removed completely during the first operation while tumor reoccurred after 3 years and was cured by reoperation in the other one case. CONCLUSION Parapharyngeal space is deep and the anatomy structure is complicated. Cancer incidence rate is low and mostly benign in this regional. Surgical resection is the preferred treatment and lateral neck approach is most commonly used. CT and MRI is an effective preoperative examination and enhanced CT reconstruction can provide a more intuitive spatial conformation.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pharyngeal Neoplasms ; surgery ; Retrospective Studies ; Young Adult

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 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 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