Surgical treatment of the carcinoma of the posterior wall of the hypopharynx

OBJECTIVE To study of the surgical methods, the results and the feasibility of laryngeal func-tion preservation of the carcinoma of the posteriorhypopharyngeal wall. METHODS A retrospective studyof 21 cases with the carcinoma of the posteriorhypopharyngeal wall whom were treated from 1997 to2003 was carried out. There were 19 males and 2 fe-males and the ages ranged from 35 to 78 years. Of the21(stageⅠ,2;Ⅱ,3;Ⅲ,4;Ⅳ,12) cases,6 were reconstrutedby re-suturing mucosa, 2 by intermediate split skin flap,1 by cervical skin flap,7 by laryngotracheal flap,1 by pec-toralis major myocutaneous flap,1 by laryngotracheal flapand pectoralis major myocutaneous flap, and 3 by gas-tric pull-up or colon interposition. Ten cases underwentunilateral elective or modified radical neck dissection and11 cases underwent bilateral neck dissection. Five cases(23.8 %) had cervical lymph nodes metastasis. Nineteencases had postoperative radiotherapy. RESULTS All thepatients restored the deglutition functions satisfactorily.Eleven cases restored the laryngeal functions completelyor partially. All patients were followed up from 6 monthsto 7 years. The 3 and 5 year survival rate were 38.5 %(5/13)and 33.3 %(1/3) respectively. CONCLUSION Posteriorhypopharyngeal wall T1-2 lesions were feasible to preservelaryngeal functions completely and carefully selected T3-4lesions were feasible to preserve laryngeal functions partially.The Kinds of surgical procedures and reconstructive tech-niques were very important for the eradication of the tumorand preservation of the laryngeal functions.