[Preservation of laryngeal function in surgical treatment of hypopharyngeal carcinoma]

To study of the feasibility, the surgical techniques and the results of laryngeal function preservation in surgical treatment of hypopharyngeal carcinoma.

A retrospective review of 305 (279 males, 26 females, ages ranging from 14 to 77 years) cases with malignant neoplasms of the hypopharynx that were treated from 1978 to 1996 were accomplished. Of the 305 (stage I, 6; II, 12; III, 82; IV, 205) cases, 234 were originated from pyriform sinus, 21 from postcricoid, 35 from posterior pharyngeal wall and 15 from superior hypopharynx. Two hundred and eighty-five patients received 55-75 Gy postoperative radiotherapy.

The overall 5 year survival rate of 305 patients was 44.8%; for stage I, the survival rate was 83%; stage II, 71%; stage III, 58% and stage IV, 36.5%. Of the 305 patients, 206 cases (67.54%, stage I, 6; II, 12; III, 65; IV, 123) were surgically treated with laryngeal functions preserved and 99 (32.46%, stage III, 17; IV, 82) total laryngectomy. There were no significant differences in 5-year survival between the functionally preserved group and none functional group. Among the 206 functional preserved patients, 139(67.5%) had all functions preserved (voice, respiration and deglutition) and 67(32.5%) partially preserved (voice and deglutition).

Only a few patients (31/305, 10%) of hypopharyngeal carcinomas require total laryngectomy, and the preservation of the normal part of the larynx is feasible for the eradication of tumor and preservation of laryngeal function.