Hemi-pharyngolaryngectomy and laryngeal reconstruction with free flaps in T3 and T4 hypopharyngeal cancer

Abstract

Resection of local advanced hypopharyngeal cancer often results in laryngeal preservation impossible. Free flaps were used to reconstruct and to preserve functional larynx. Retrospective review of 11 patients who underwent resections of extended squamous cell carcinoma of hypopharynx from September 2005 to September 2011. Of 11 patients, 5 had T3 lesions and 6 had T4 lesions; 2 underwent radiotherapy before surgery and other 9 had postoperative radiotherapy (60 Gy). A total of 12 free flaps, including 10 radial forearm flaps and 2 anterolateral thigh flaps, was used in the 11 patients for laryngo pharyngeal reconstruction. The 3 year over all survival rate and disease-specific survival rate were 43.6% and 48.0%, respectively. The incidence of surgical complications was 72.7%, including 1 with carotid blow-up, 2 flap failure, 3 fistula, and 1 stenosis. The rate of decannulation was 72.7%, 90.9% patients were with oral feeding and 81.8% patients achieved reasonable speech. Free flaps can be used to reconstruct a functional larynx in local advanced hypopharyngeal carcinoma, ensuring a better quality of life for patients.