Carcinoma of the posteior pharyngeal wall - larynx preservation with the radial forearm flap or transoral resection

english

1997

volume 31, issue 2

Onkološki inštitut Ljubljana

In a series of 15 patients with advanced (T2 and T4) tumors of the posterior hypopharyngeal wall, we tried to preserve the larynx during surgical therapy. Four patients with T2 tumors and with limited invasion of the lateral pharyngeal wall were resected transorally under microscopic control. In 9 cases, the access to the pharynx was done with lateral pharyngotomy and the pharynx was reconstructed in 8 cases with a radial forearm flap and in one case with a jejunal transplant. Two patients preferred radiotherapy or combined chemo-radiotherapy. One patient die after transoral tumor resection due to ostemyelitis of the cervical vertebral spine. The other three patients of this group learned to swallow within the period of four months. Three months after the reconstruction of the posterior pharyngeal wall with free flaps, 7 patients were able to swallow without aspiration. One patient needed 4 month to swallow without aspiration. One year after the reconstruction, one patient still needs tracheotomy because of aspiration problems. Surgical resection of advanced tumors of the posterior pharyngeal wall is possible without laryngectomy. The reconstruction with the radial forearm flap is preferred for T4 tumors with extension to the lateral pharyngeal areas and transoral resection under microscopic control is useful for T2 tumors.

10.11.2023