JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2016, Vol. 30 ›› Issue (3): 20-23.doi: 10.6040/j.issn.1673-3770.0.2016.262

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Treatment experience of preservation of laryngeal function in surgical management of pyriform sinus carcinoma.

SONG Xicheng1, ZHANG Hua1, LIU Zhonglu1, WANG Yunqiang2, WANG Yan1, ZHANG Qiang1, WANG Qiang1, KANG Shasha1, SONG Yipeng   

  1. 1. Department of Otorhinolaryngology Head and Neck Surgery;2. Department of Head and Neck Radiology;3. Department of Radiation Oncology, Yantai Yuhuangding Hospital, Yantai 264000, Shandong, China
  • Received:2016-05-20 Online:2016-06-16 Published:2016-06-16

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Abstract: Objective To investigate preservation and reconstruction of larynx function in surgical treatment of pyriform sinus carcinoma. Methods A retrospective analysis of 102 cases of pyriform cancer treated in June 2004 to October 2015 underwent surgeries with laryngeal functions preserved was carried out. There were 9 cases of stage Ⅰ, 11 cases of stage Ⅱ, 47 cases of stage Ⅲ and 35 stage Ⅳ, according to the 2002 UICC staging. Pharyngeal lateral wall approach, hyoid region approach and paraglottic space approach were chosen respectively to remove the tumor as per preoperative evaluation, followed by repairing of surgical defects and reconstruction of laryngeal and pharyngeal functions. 93 cases of postoperative radiotherapy were implemented. Results All patients recovered well after surgery except 1 patient with pharyngeal fistula and infection. All repairing materials of different methods survived and the average time of postoperative oral intake was 12.47 days. All patients retained good laryngeal functions with 95 decannulations and the 3-year and 5-year survival rates were 59.3% and 40.7% respectively. Conclusion Comprehensive preoperative investigations as laryngoscopy and radiological assessment may give good suggestions in selecting appropriate surgical approaches; good surgical approach may help provide good feasibility and visibility, and ensure complete removal of the tumors with safety margins; through the epiglottis flipping and/or thyroid reinforcement repairing methods, the incidence of accidental swallowing and pharyngeal fistula can be reduced; pyriform sinus carcinoma are found mostly in advanced stages, single treatment is often ineffective in controlling the lesion, and radiotherapy is necessary as a comprehensive treatment to improve the local control rate and survival rate. Appropriate surgical approaches and repairing methods can help surgeons to completely remove the tumor, and preserve or rebuild laryngeal and pharyngeal functions in managing chosen patients with pyriform sinus cancer.

Key words: Pyriform carcinoma, Reconstruction, Laryngeal function

CLC Number: 

  • R766.9
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