关键词: 咽肿瘤, 咽切除术, 喉切除术

Abstract: Objective：To study the surgical technique and results of surgical treatment for medial wall pyriform sinus cancer. Methods： A total of 122 patients with medial wall pyriform sinus cancer were surgically treated in our department between 1990 and 2001. Among them, 5 were in stage Ⅰ, 8 in stage Ⅱ, 37 in stage Ⅲ, and 72 in stage Ⅳ. Partial resection of the pyriform sinus and partial laryngectomy were performed on 87 cases. Epiglottis and sternohyoid myofascial flaps were used for laryngeal reconstruction. The remaining hypopharyngeal mucosa, pectoralis major musculocutaneous flap and colon interposition were used to cover the wound of hypopharynx and for artificial rebuilding. All patients received postoperative radiotherapy. Results：The overall 3 and 5year survival rates were 67.2％（82/122）and 45.1％（55/122）, respectively. In the preservative surgery group, the 3  and 5year survival rates were 71.3％（62/87） and 48.3％（42/87）, respectively, whereas those in the total laryngectomy group were 57.1％（20/35）and 37.1％（13/35）, respectively. Laryngeal functions were completely restored in 71.3%(62/87) and partially in 28.7% (25/87)of the total laryngectomy group. Conclusion： Although the medial wall pyriform sinus cancer tends to have a laryngeal invasion, preservative surgery should be practiced for the majority of patients after the lesions have been entirely removed.

Key words: Pharyngectomy, Laryngectomy , Hypopharyngeal neoplasms