title: Functional results with advanced hypopharyngeal carcinoma treated with circular near-total pharyngolaryngectomy and jejunal free-flap repair.
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France. temam@igr.fr
authors.forename: Stephane
authors.initials: S
authors.lastname: Temam
authors.forename: Francois
authors.initials: F
authors.lastname: Janot
authors.forename: Michel
authors.initials: M
authors.lastname: Germain
authors.forename: Morbize
authors.initials: M
authors.lastname: Julieron
authors.forename: Evelyne
authors.initials: E
authors.lastname: Bretagne
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Myers
authors.forename: Patrick
authors.initials: P
authors.lastname: Marandas
authors.forename: Gerard
authors.initials: G
authors.lastname: Mamelle
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Leridant
authors.forename: Frederic
authors.initials: F
authors.lastname: Kolb
authors.forename: Bernard
authors.initials: B
authors.lastname: Luboinski
mesh_terms: 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