Contralateral hemilaryngotracheal flap reconstruction of the hypopharynx in pyriform carcinoma resection.

OBJECTIVES

To simplify the approach and reconstruction for advanced hypopharyngeal cancer, a modified technique-laryngotracheal fissure approach and laryngotracheal flap reconstruction--is presented.

STUDY

DESIGN

Prospective.

METHODS

From August 1991 to December 1995, 44 consecutive patients with advanced hypopharyngeal cancer, mostly involving pyriform sinus, were operated on with this technique. The functional and oncologic results and complications were evaluated.

RESULTS

Reconstruction was completed by using the laryngotracheal flap in 75% of patients, while the other 25% required additional patch-on pectoralis major myocutaneous flaps. Pharyngoesophageal stenosis occurred in one patient after radiotherapy and pharyngocutaneous fistula was noted in two. No local recurrence was noted. Seven cervical metastases developed in the follow-up period and six over the contralateral neck not treated surgically. The 5-year Kaplan-Meier disease-free survival was 46.8%.

CONCLUSIONS

The authors' experience indicates that this is a simplified, radical treatment for most advanced hypopharyngeal cancer, with high applicability, good oncologic results, and low complication.