Aged ; Humans ; Male ; Pharyngeal Neoplasms ; Polyps ; Pyriform Sinus ; pathology

Humans ; Male ; Middle Aged ; Pharynx ; pathology ; Pyriform Sinus ; Thyroglossal Cyst ; surgery

OBJECTIVETo study the early diagnosis, treatment and Prognosis of pyriform sinus perforation.

METHODSTo study the clinical feature about 15 cases of pyriform sinus perforation, Most of the 15 cases with pyriform sinus perforation were associated with pharyngeal pain or fever. contrast x-ray studies and CT scan were used to confirm the perforation. conservative treatment in 9 cases and surgical intervention in 6 cases. and review relevant literature.

RESULTSOf all 15 cases, 9 cases with wild symptoms for conservative treatment, 6 cases with severe symptoms and complications were treated surgically. All achieved better clinical efficacy, By relevant examination, the perforation were healed within 2 - 4 weeks and none had re-perforation for 1 - 30 months follow-up.

CONCLUSIONSPyriform sinus perforation with wild symptoms and within 12 hours can be treated conservatively. Large perforation (> 2 cm) last more than 12 hours or any complications require exploration, operation repair if possible and adequate drainage. early diagnosis and effective treatment can reduce the incidence of complications and improve the survival rate of patients.

Adult ; Aged ; Early Diagnosis ; Female ; Humans ; Middle Aged ; Pharyngeal Diseases ; diagnosis ; therapy ; Pyriform Sinus ; pathology

OBJECTIVETo establish the rabbit VX2 tumor as a model for pyriform sinus carcinoma and to observe its biological features.

METHODSVX2 tumor was implanted into the pyriform sinus of 15 rabbits by direct laryngoscope. Fifteen rabbits were randomized into 3 groups (average of 5 rabbits per group). Observation of the tumor growth and evaluation of the histopathological characterization were taken on one group each at the of time 14, 21 and 28 days after transplantation respectively.

RESULTSTumors were found grown in the pyriform sinus of all 15 rabbits with a success implantation rate of 100%. Dysphagia, body weight loss, rhinorrhea and short of breath appeared in the rabbits 28 days after transplantation. The metastasis rates of deep cervical were 100% in all three groups. The metastasis rates of submandibular lymph nodes were 3/5, 4/5 and 5/5 in 14-day, 21-day and 28-day group respectively. The metastasis rates of paratracheal lymph nodes were 0, 4/5 and 5/5 in 14-day, 21-day and 28-day group respectively. There were opposite side lymph node metastasis of deep cervical, submandibular and paratracheal in 4, 3 and 5 rabbits on 14, 21 and 28 days after transplantation respectively. The median diameter for deep cervical, submandibular and paratracheal neck lymph nodes were 1.50, 0.60 and 0.0 cm in 14 days; 1.60, 0.80 and 0.50 cm in 21 days; 1.80, 0.8 and 0.65 cm in 28 days (P > 0.05).

CONCLUSIONSThe animal model for pyriform sinus carcinoma is established successfully. The metastasis of deep cervical lymph node could be induced from day 14 after VX2 transplantation.

Animals ; Disease Models, Animal ; Hypopharyngeal Neoplasms ; pathology ; Lymphatic Metastasis ; pathology ; Neoplasm Transplantation ; methods ; Pyriform Sinus ; pathology ; Rabbits

Objective:To investigate the clinical manifestations and treatment of laryngopharynx hamartoma in children. Methods:The clinical data of a child with piriform sinus hamartoma treated in our hospital were analyzed retrospectively. The age, gender, clinical manifestations, auxiliary examination, location of the tumor and surgical methods were analyzed. Results:The patient had a good prognosis after surgery, and no tumor recurrence was found after 1 year of follow-up. Conclusion:Laryngopharynx hamartoma is rare in children. It should be considered in children with laryngeal dysfunction and upper airway obstruction. Complete resection of the tumor is the key to postoperative recurrence.
Child ; Humans ; Hamartoma/surgery* ; Larynx/pathology* ; Neoplasm Recurrence, Local/pathology* ; Pyriform Sinus/pathology* ; Retrospective Studies ; Male ; Female

OBJECTIVE: To explore the diagnosis and treatment of the ectopic parathyroid gland in the pyriform sinus. METHOD: Retrospectively analysis of 1 case with ectopic parathyroid gland in the pyriform sinus and retrospectively review the past literatures. RESULT: The cases with the ectopic parathyroid gland in the pyriform sinus reported in the past literatures included: 2 with parathyroid gland tissues, 3 with hyperplasia, the other 1 with adenoma. The case reported by us was with adenoma. CONCLUSION The ectopic parathyroid gland hyperplasia in the pyriform sinus is rarely reported before and it usually causes misdiagnosis. Better knowledge of the different position of the ectopic parathyroid gland hyperplasia in the pyriform sinus will help diagnosing and treating it.
Choristoma ; diagnosis ; therapy ; Female ; Humans ; Hyperplasia ; therapy ; Middle Aged ; Parathyroid Diseases ; diagnosis ; therapy ; Parathyroid Glands ; pathology ; Pyriform Sinus ; pathology

OBJECTIVE: To investigate the characteristic of cervical lymph node metastasis of pyriform sinus carcinoma. METHOD: One hundred and two pyriform sinus carcinoma patients who accepted treatments in the EENT Hospital of Fudan University from 1990 to 2006 were reviewed retrospectively. All of them did not have any treatment and received surgical treatment in our hospital. Stage was made according to the standard of International Union Against Cancer (UICC)in 1997. The distribution of cervical lymph node was confirmed by CT scanning and pathology. RESULT: The rates of lymph node metastasis were 16.7% , 59.4%, 70.8% and 63.6% for patients with T1 disease, T2, T3 and T4 (P <0.05), respectively, and 62.7% (64/102) for the whole patients. The bilateral metastasis rate were 2.70% (1/37), 12.5% (6/48) and 18.1% (2/11) for T2, T3 and T1, respectively (P <0.05). The occurrence of cervical lymph node metastasis was 3.87% in the level I , 33.55% in the level II, 30.97% in the level III, 25.16% in the level IV, 5.16% in the level V, 1.29% in the level VI (P <0.05). Fourteen patients with cN0 stage had modified neck dissection and 10 patients had lymph node metastasis (71.4%). The lymph node metastasis of cN0 and cN1 was all in the level II, level III and level IV. And cN2 and cN3 also had some in the level I, level V and level VI. CONCLUSION T2, T3 and T4 all had high rates for lymph node metastasis while T3, T4 were easier for contralateral metastasis. T3, T4 and contralateral metastasis were easier to surpassing the lymph node envelope. The lymph node metastasis of cN0 and cN1 was all in the level II, level III and level IV. And cN2 and cN3 also had some in the level I, level V and level VI.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hypopharyngeal Neoplasms ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; pathology ; Neoplasm Staging ; Pyriform Sinus ; pathology ; Retrospective Studies

OBJECTIVETo explore the regularity invading adjacent tissue of pyriform sinus carcinoma.

METHODSThe whole organ serial section of 68 total or partial laryngectomy and hypopharyngectomy specimen of pyriform sinus carcinoma were histopathologically studied.

RESULTSIn 68 pyriform sinus carcinoma, invaded ventricular and paraglottic spaces was 63 and 38 cases respectively, the difference of invasive frequency of both spaces was significantly marked (chi2 = 21.37, P < 0.01). Thyroid cartilage had the most invaded frequency of 92.6% (63/68). The all touching and pressing invasion of laryngeal cartilage was 89 times, and infiltrating invasion was 51 times. The invasive frequency of lateral cricoarytenoid muscle, posterior cricoarytenoid one, thyroarytenoid and interarytenoid ones were 63.2% (43/68), 57.4% (39/68), 55.9% (38/68), 51.5% (35/68) respectively. The invasive frequency of cricoarytenoid and cricothyroid joints were 30.9% (21/68), 17.6% (12/68) respectively. The invasive frequency of superior laryngeal nerve was 67.7% (44/65) , and more than that of recurrent laryngeal nerve (18/65, 27.7%). The pyriform sinus medial wall carcinoma was 14 cases, lateral wall carcinoma 18 cases, medial and lateral wall carcinoma 36 cases. The invaded pyriform sinus apex was 34 cases, normal its apex was 26 ones, submucous invasion of its apex was 8 ones. Light lymphocytic invasion was 66.2% (45/68) and seen most in pyriform sinus carcinoma. Submucous and leaping invasion of pyriform sinus carcinoma were 24 and 8 cases.

CONCLUSIONSIntralaryngeal invasion of pyriform sinus carcinoma arose through paraglottic space first. Laryngeal cartilage membrane and their cartilage were anatomical obstacle against cancerous invasion. Lateral cricoarytenoid muscle, posterior cricoarytenoid one, thyroarytenoid and interarytenoid ones were often invaded. Pyriform sinus medial wall carcinoma invaded intralaryngeal structure easily, its lateral wall carcinoma may invade upward, downward and outward along thyroid cartilage interior wall, medial and lateral wall carcinoma may invade intralaryngeal and extralaryngeal structure, and was the most serious lesion. The invasion of pyriform sinus apex is an important sign of pyriform sinus carcinoma spreading downward to inferior and peripheral tissues of hypopharynx.

Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; Female ; Humans ; Hypopharyngeal Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Pyriform Sinus ; pathology

OBJECTIVETo evaluate the efficacy of surgery for the patients with pyriform sinus carcinoma and analyze the prognostic factors related to the cancer.

METHODSBetween December 1995 and December 2002, 62 patients with pyriform sinus cancer were treated in Zhejiang Tumor Hospital. There were 13 patients staged T1, 17 T2, 12 T3, 20 T4. Four patients received preoperative radiation and 40 patients had post-operative radiation. Among 62 patients, 33 patients were treated by partial laryngectomy, 29 patients were treated by total laryngectomy.

RESULTSThe survival rate was calculated with Kaplan-Meier method. The overall 3- and 5-year survival rates were 42.3% and 27.8%, respectively. The 3-year survival rate between partial and total laryngectomy was 51.9% and 29.9%. The 5-year survival rate between partial and total laryngectomy was 39.5% and 11.2% (chi2 = 4.14, P<0.05). Early stage and combined modality therapy were the independent favorable prognostic factors.

CONCLUSIONSEarly diagnosis with treatment and combined treatment are the most important factors influencing the survival of patients with pyriform sinus carcinoma. Partial laryngopharyngectomy is a suitable treatment for early and selected advanced pyriform sinus carcinoma with a good function and oncologic outcome.

Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; therapy ; Combined Modality Therapy ; Humans ; Hypopharyngeal Neoplasms ; mortality ; therapy ; Laryngectomy ; Male ; Middle Aged ; Pharyngectomy ; Pyriform Sinus ; pathology ; Survival Rate

OBJECTIVE: To investigate the feasibility and results of laryngeal functional preservation surgery for piriform sinus carcinoma with paraglottic space involvement. METHOD: Fourteen cases of piriform sinus carcinoma with paraglottic space involvement were reviewed. Laryngoplasty was performed after tumor was resected, bilater al selective neck dissections were performed at the same stage. Postoperative chemoradiotherapy was applied to 11 patients while the other 3 patients did not receive chemotherapy nor radiotherapy. The follow-up time ranged from 6 months to 5 years, and the mean follow-up time was three and a half years. RESULT: Twelve cases healed primarily while 2 cases experienced delayed heal because of pharyngeal fistula. Postoperative swallow bucking occurred in all patients, the longest gastric feeding time was 2 months. For the patients underwent postoperative chemoradiotherapy, the tumor did not recur in ten cases during the 3 years follow-up, while recurred in another case and the patient died without further treatment. Among those 3 cases without postoperative radiotherapy or chemotherapy, the tumor recurred in 2 cases during the following 6 months and chemoradiotherapy was applied, no recurrence presented in one patient, another one lost of follow-up. For the patient with recurred tumor 8 months after surgery, total laryngectomy was employed with postoperative chemoradiotherapy, the case died of tumor recurrence one and half year after the first surgery. The 3-year survival rate was 78.6%. For the vocal cord at lesion side, the mobility was noticeable in 6 patients, and visible anatomic landmark was lost in the other 8 patients. CONCLUSION Laryngeal function preservated surgery could be performed in selected cases of piriform sinus carcinoma with para-glottic space involvement in order to achieve better clinical results and quality of life.
Aged ; Carcinoma ; surgery ; Female ; Follow-Up Studies ; Glottis ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; physiology ; Male ; Middle Aged ; Organ Sparing Treatments ; Pyriform Sinus ; pathology ; Retrospective Studies ; Treatment Outcome