[The posterior pharyngeal wall in pharyngo-laryngeal cancer. Spontaneous healing after excision].
Malignant lesions arising from the posterior pharyngeal wall, or spreading to involve it, present a therapeutic problem in cancer surgery as witnessed by the number of techniques proposed and used. In general, they require longer operating time, sometimes need a double team of surgeons and sometimes specialised training. There is an increased risk of complications. The experience with pharyngoplasty using mucosal or musculo-mucosal flaps, which leave the donor site bare, raised the possibility of partial repair in circular pharyngo-laryngectomy. A myocutaneous flap is sutured in "gutter" fashion anteriorly opposite the posterior pharyngeal wall which in fact consists of the prevertebral aponeurosis laid bare. Repair was not performed in certain partial posterior pharyngectomies. Seven patients underwent surgery using this technique. Four circular pharyngo-laryngectomies, including 2 as second stage procedures were performed. Healing occurred in all cases. No breakdown of sutures occurred. Oral feeding was possible from D12 on average and patients were discharged on D18. Three posterior pharyngectomies, including 1 as a second stage procedure, were performed. Feeding was possible in 2 patients on D15 and discharge on D18. These encouraging results suggest that this reliable, rapid single stage procedure technique should be adopted.
Lelièvre
G
G
Service ORL, Hôpital Intercommunal de Créteil.
Juvanon
J M
JM
Sautreuil
B
B
Martin
M
M
Poignonnec
S
S
Peynègre
R
R
D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009333:Neck; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D010611:Pharyngectomy / Q000379:methods*; D010614:Pharynx / Q000473:pathology; D013524:Surgical Flaps; D013536:Suture Techniques; D014140:Tracheotomy; D014945:Wound Healing
La paroi pharyngée postérieure dans les cancers pharyngo-laryngés. Cicatrisation spontanée après exérèse.