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

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

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

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

The principle treatment for cervical esophageal cancer and hypopharyngeal cancer with esophageal invasion is radical total pharyngolaryngoesophagectomy (PLE), and it is necessary to totally reconstruct the defect of the resected organ. Stomach, small bowel, colon, a laryngotracheal flap and a pectoralis major musculocutaneous flap can all be used. We commonly use stomach because stomach has a rich blood supply and a low incidence of leakage. But in this present reported case, because previous radical subtotal gastrectomy with gastrojejunostomy had been done, we had to use colon for reconstruction. We use the left colon and left colic artery, and there were no complications. We report here on using the left colon and left colic artery to reconstruct a PLE defect for the first time in Korea.
Arteries ; Colic ; Colon* ; Esophageal Neoplasms ; Gastrectomy* ; Gastric Bypass ; Humans ; Hypopharyngeal Neoplasms ; Incidence ; Korea ; Myocutaneous Flap ; Pharyngeal Neoplasms ; Stomach

Humans ; Pharyngeal Neoplasms ; Esophageal Neoplasms/surgery*

No abstract available.
Female ; Humans ; Lipoma/*pathology ; Pharyngeal Neoplasms/*pathology

Aged ; Female ; Humans ; Neurilemmoma ; Pharyngeal Neoplasms

Myxolipomas, or myxoid lipomas, are unusual histologic types of lipoma in which components of the tumor are replaced by mucoid substances. Lipomas of the parapharyngeal space are extremely rare with only a few cases having been reported. The presence of myxolipoma in the parapharyngeal space has not yet been reported in the literature. We present the first report of a 14-year-old female with myxolipoma in the left parapharyngeal space which was excised via a transcervical approach.
Adolescent ; Female ; Humans ; Lipoma ; Myxoma ; Pharyngeal Neoplasms

The patient was hospitalized for foreign body sensation at pharynx persisted for two months. The patient noticed that the left pharyngeal palate was elevated two months ago and was treated as pharyngitis without success. Because of no eating difficulty, loss of voice or sore throat, the patient did not seek for further treatment. Recently the foreign body sensation at pharynx was worsened and the elevation at left pharyngeal palate enlarged and affected pronunciation and speech. A bulge about 4 cm x 5 cm in size was found around left soft palate and tonsil, relatively hard in texture; The mucosal membrane of the bulge was intact with slight hyperemia. The bulge was not movable and exhibited no tenderness to touch and no bleeding to press. Left tonsil was swelling of degree I degrees, grayish white and unsmooth on the surface. Uvula was deviated slight to the right. The soft palate movement was not satisfactory. No swelling on right tonsil. The CT indicated a soft tissue mass at left parapharyngeal space, about 3.4 cm x 5.4 cm in size. leiomyosarcoma (pharynx).
Humans ; Leiomyosarcoma ; Male ; Middle Aged ; Pharyngeal Neoplasms