Lateral conservative approach for recurrent/persistent hypopharyngeal carcinoma: a case series

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Oncology

Background:

• Recurrent hypopharyngeal tumors pose significant surgical challenges, requiring a balance between oncological radicality and laryngeal function.
• Preserving laryngeal function is crucial for patient quality of life after treatment for hypopharyngeal cancer.

Purpose of the Study:

• To evaluate the technical feasibility of lateral hypopharyngectomy with laryngeal preservation for early recurrent hypopharyngeal tumors.
• To assess functional outcomes and oncological radicality in patients undergoing this surgical approach post-radio/(chemo)therapy.

Main Methods:

• Retrospective review of patients with recurrent T1 hypopharyngeal squamous cell carcinoma.
• Modified lateral hypopharyngectomy with laryngeal preservation using an external lateral approach.
• Reconstruction with thyroid cartilage approximation and vascularized anterobrachial fascial flap.

Main Results:

• The surgical procedure was technically feasible, achieving complete tumor resection in all cases.
• No major post-operative complications were observed; mild dysphagia was managed with rehabilitation.
• No recurrence was noted after a median follow-up of 20 months, with all tracheostomies closed.

Conclusions:

• Lateral hypopharyngectomy with laryngeal preservation is a viable option for selected cases of lateral hypopharyngeal cancer.
• This technique allows for radical tumor removal while maintaining acceptable functional results and quality of life.