Functional results with advanced hypopharyngeal carcinoma treated with circular near-total pharyngolaryngectomy and jejunal free-flap repair.
BACKGROUND
Patients treated by a circular pharyngolaryngectomy for advanced hypopharyngeal carcinoma have a poor prognosis and disappointing speech restoration.


METHODS
Three carefully selected patients underwent a near-total laryngectomy circular pharyngectomy with jejunal free flap repair and dynamic tracheopharyngeal shunt for treatment of advanced hypopharyngeal carcinoma. They received induction chemotherapy and postoperative radiotherapy. We assessed the functional outcome.


RESULTS
There was no major local complication. One year after the end of radiotherapy, all patients were able to eat solid diets. Two patients were able to speak immediately after the end of the treatment. After speech re-education, a high-quality tracheopharyngeal voice was restored in all three patients. Performance Status Scale for Head and Neck Cancer Patients (PSSHN) showed a mean score equal to 81/100 at 1 year.


CONCLUSIONS
In selected patients, near-total laryngectomy circular pharyngectomy with tracheopharyngeal shunt and jejunal free-flap repair offers good voice rehabilitation without impairing swallowing function.
Temam
Stephane
S
Department of Otorhinolaryngology-Head and Neck Surgery, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France. temam@igr.fr
Janot
Francois
F
Germain
Michel
M
Julieron
Morbize
M
Bretagne
Evelyne
E
Myers
Jeffrey N
JN
Marandas
Patrick
P
Mamelle
Gerard
G
Leridant
Anne-Marie
AM
Kolb
Frederic
F
Luboinski
Bernard
B
D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy / Q000009:adverse effects / Q000379:methods; D018714:Radiotherapy, Adjuvant; D013064:Speech Disorders / Q000209:etiology / Q000534:rehabilitation; D013071:Speech, Alaryngeal; D013524:Surgical Flaps; D016896:Treatment Outcome