Surgical treatment for posterior hypopharyngeal wall carcinoma

Objective:To study the surgical treatment and the simultaneous reconstruction methods for posterior hypopharyngeal wall carcinoma.Methods: Thirty-five cases of the posterior hypopharyngeal wall carcinoma were retrospectively reviewed.According to UICC 1997 criteria,there were 2 in stageⅠ,7 in stage Ⅱ,10 in stage Ⅲ,and 16 in stage Ⅳ.Twenty cases preserved the complete or partial laryngeal functions and 15 cases accepted the total laryngectomy.Nineteen cases underwent an unilateral elective or modified radical neck dissection and 15 underwent a bilateral neck dissection.Thirty-three patients received radiotherapy postoperatively (50-70 Gy).Results: The deglutition function was restored within 2 months.Vocal function was acquired in 20 patients preserving the laryngeal function and trachea cannulas were removed in 15 patients.The 5-and 3-year survival rates were 31.6%(6/19)and 44.4%(12/27),respectively. Conclusion: Carcinoma of the posterior hypopharyngeal wall are few in clinic.Surgical resection and one-stage hypopharyngeal reconstruction are feasible.The phary-esophagus passage could be restored by retaining the mucosa,pectoralis major myocutaneous flap,laryngotracheal flap,split skin flap,stomach transposition and colon interposition etc.