关键词: 下咽肿瘤, 喉肿瘤, 颈部重建

Abstract: Objective:To explore how to repair the hypopharyngeal and cervical defects after carcinoma removal in patients with hypopharyneal carcinoma of the advanced stage and laryngeal recurrent carcinoma. Method:36 cases of recurrent laryngeal carcinoma were treated. The defects of 18 cases were repaired with pectoralis major flaps, of 4 with deltopectoralis skin flaps, of 2 with stomach replaced esophagus and of 12 with the flap shift from thoraces to cover the dead space. Also 16 cases of late hypopharyngeal and eight cases of cervical esophageal carcinoma were treated in this study. The defects of 1 case was repaired with jejunal interposition, of 8 with laryngeal mucosal flaps from the uninjured side, of 8 with laryngotracheal interpositions, of 2 with pectoralis major flaps, of 2 with stomach replaced esophagus,and of 1 with a free antebrachial flap.Results: No one died during the operations and no reconstructed tissue necrosis happened after the operations. All flaps survived. In cases repaired with laryngeal mucosal flaps, only 1 with pre-operational radiotherapy suffered from pharyngeal fistula. 1 case was repaired with a pectoralis major flap and 1 with a stomach replaced esophagus suffered from a pharyngeal fistula. All patients could intake semi-fluid after healing. Followed up for 9 to 84 months, 14 patients had dysphagia but still could intake semifluid. Conclusions:All kinds of ways to reconstruct the defect of hypopharynx are good in different aspects and have different indications. Location of the tumor and size of the defects are the most important factors for choosing the reconstruction method. Also, complications should be decreased.

Key words: Hypopharyngeal neoplasms, Laryngeal neoplasms, Neck reconstruction