Premium
Extended voice‐sparing surgery in selected pyriform sinus carcinoma: Techniques and outcomes
Author(s) -
Hamoir Marc,
Fievez Juliette,
Schmitz Sandra,
Velasco Dorris,
Lengele Benoît
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23174
Subject(s) - medicine , pyriform sinus , swallowing , surgery , laryngectomy , larynx , carcinoma , fistula
Background Organ‐preservation approaches are frequently favored in the treatment of advanced pyriform sinus carcinoma. In selected cases, use of free flaps allows voice‐sparing surgery. Methods Thirteen patients underwent conservative extended laryngopharyngectomy. In 11 patients, the resection included the supraglottic larynx, whereas the whole hemilarynx was resected in 2. Reconstruction was achieved with a radial forearm free flap with the palmaris longus tendon. In hemilarynx resection, a costal graft was also used. Functional results were assessed by nasofibroscopy and swallowing videofluoroscopic tests. Results At 12 months, no patient was gastrostomy dependent, whereas 1 patient remained tracheostomy dependent. At 1, 3, and 5 years, the locoregional control was 100%, 100%, and 83%; overall survival was 69.4%, 46.3%, and 30.8%; and disease‐specific survival was 81.2%, 54.5%, and 36.4%, respectively. Conclusions In selected patients, extended conservative laryngopharyngectomy challenges the oncologic results of organ‐preservation protocols and allows a good quality of life. © 2012 Wiley Periodicals, Inc. Head Neck 35: 1482–1489, 2013