"End to Side Technique": More organ preservation with less morbidity in patients with pyriform sinus apex SCC

Hypopharyngeal squamous cell carcinoma (SCC) is rare, but highly aggressive. Due to the advanced stage of this cancer at the time of diagnosis, radical surgery with reconstruction of pharynx is the standard care with high morbidity and mortality rate. A safer partial pharyngectomy could also be used for invasive hypopharyngeal cancer. In this study, we investigated the short and long-term outcomes in patients with SCC of the pyriform sinus apex undergoing standard partial pharyngectomy using a new suturing technique, called end to side technique.

This case series was performed on 8 patients with SCC of the pyriform sinus apex at the otorhinolaryngology clinic. All participants underwent standard partial pharyngectomy using "end to side technique". Post-operative evaluations included 6 and 12 months CT scan and 1-year barium swallow.

Of 8 patients, 7 were male (87.5%) and 1 was female (12.5%) with a mean age of 60 years old. All patients were diagnosed at stage III of hypopharyngeal cancer and cervical lymph node involvement was reported in 3 patients (37.5%). Tumor margins were negative in all patients. Fistula was reported in 2 patients (25%) which was managed using conservative treatments.

According to our study, the standard partial pharyngectomy with end to side technique is a safe and feasible method for the surgical resection of the squamous cell carcinoma of the pyriform sinus apex with good short-term and long-term outcomes.