[Functional surgery versus radical surgery in carcinoma of the hypopharynx]

A retrospective study was made of the clinical features and effectiveness of different surgical techniques in 66 patients with carcinoma of the hypopharynx treated at our hospital between 1985 and 1990. Thirty-seven patients were treated surgically and 29 were not. In the early stages, surgical treatment was functional: 15 patients had hemipharyngolaryngectomy or partial pharyngectomy. In advanced, but operable, stages, radical surgery was performed: 22 patients underwent total laryngectomy with partial pharyngectomy or total pharyngolaryngectomy. In 15 cases, reconstruction was needed; a muscle flap of pectoralis major yielded good results. Survival after a 5-year follow-up was 60% in cases treated with functional surgery and 37% in those treated with radical surgery. Functional surgery enabled decannulation of 65% of patients.