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Hypopharynx
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The hypopharynx is the caudal part of the pharynx, also called laryngopharynx, extending from the hyoid bone to the lower margin of the cricoid cartilage. Hypopharyngeal cancers are distinctly different from laryngeal cancers in terms of presentation, management, and prognosis. Hypopharyngeal cancers make up 5–10% of head and neck cancers, and the presentation is often vague, with up to 80% presenting as stage III or IV disease. These factors lead to overall poorer outcomes than are experienced with other head and neck cancers.
Management of Ballistic Face and Neck Trauma in an Austere Setting
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Damage to the hypopharynx and oesophagus may be clinically silent and escape serial physical examinations. Missed oesophageal injuries are the cause of the majority of delayed complications seen with penetrating neck injuries. Early signs of oesophageal injury include subcutaneous air, crepitus, dysphagia, odynophagia, drooling, and hematemesis. When an oesophageal leak progresses to mediastinitis, morbidity and mortality are significant.
Hypopharynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Patrick J. Bradley, Neeraj Sethi
The hypopharynx communicates superiorly with the oropharynx and inferiorly with the oesophagus, and is located posterior to the larynx. The superior border of the hypopharynx is an imaginary line from the superior level of the hyoid bone (or floor of the valleculla). The inferior boundary is anteriorly formed by the aryepiglottic folds that separate the hypopharynx from the larynx and posteriorly is the level of the inferior border of the cricoid cartilage and the apex of one piriform sinus to the other [1].
High pretreatment platelet-to-lymphocyte ratio is related to poor prognosis in the squamous cell carcinoma of the larynx and hypopharynx in male patients
Published in Acta Oto-Laryngologica, 2021
Han Zhou, Panpan Song, Yajun Gu, Junguo Wang, Hui Li, Xia Gao, Xiaoyun Qian
Larynx and hypopharynx are neighboring structures that are functionally integrated and surgically related. According to the GLOBOCAN 2018 report by the International Agency for Research on Cancer, worldwide incidence of the laryngeal and hypopharyngeal cancers is about 1% and 0.4% of all sites, respectively [1]. As the most common pathological type, the squamous cell carcinoma (SCC) has a poor overall survival (OS) rate [2]. Compared to females, male patients have a circa sevenfold cumulative risk [3]. Fully assimilate the nature of laryngeal/hypopharyngeal SCC (LHSCC) mainly relies on pathology of the surgical specimen including tumor invasion, nodal involvement, perineural and lymphovascular invasion, and distant metastases. However, the main drawback is that these indexes can only be assessed after surgery.
Clinical outcomes of end-flexible-rigidscopic transoral surgery (E-TOS) in patients with T1-selected T3 pharyngeal and supraglottic cancers
Published in Acta Oto-Laryngologica, 2019
Yoshiki Watanabe, Shinzo Tanaka, Yasuyuki Hiratsuka, Hiroshi Yamazaki, Takao Yoshida, Junko Kusano, Isao Morita, Momoko Matsunaga, Masayuki Kitano, Tomoya Yamaguchi
The results of the present study clearly showed that E-TOS was effective for T2 and selected T3 pharyngeal and supraglottic cancers, but we experienced one patient with T2 hypopharynx cancer who suffered from stenosis of hypopharynx and esophageal entrance after postoperative chemoradiotherapy. In this case, the mucosal defect after E-TOS exceeded semi-circumference of the esophageal entrance. Although this patient had a normal meal 21 days after E-TOS, temporal swallowing dysfunction occurred a month after the postoperative chemoradiotherapy, which improved by balloon dilation to pharyngeal and esophageal lumen. When mucosal defect is prospected to exceed semi-circumference of the esophageal entrance, application of E-TOS should be carefully considered because combination of large defect of mucosa and postoperative chemoradiotherapy may cause stenosis at this region.
The impact of surgical margin status on the outcomes of locally advanced hypopharyngeal squamous cell carcinoma treated by primary surgery
Published in Acta Oto-Laryngologica, 2018
Min Li, Ming Xie, Liang Zhou, Shuyi Wang
Regarding the poor prognosis of hypopharyngeal carcinomas, multidisciplinary management was indicated for advanced hypopharyngeal carcinoma [2]. Surgical resection followed by adjuvant treatments remained the major therapeutic option for advanced hypopharyngeal carcinomas. Oncologically, safe resection of the primary tumor played an imperative role in carcinoma management [3]. Wei [4] recommended hypopharyngeal margins of 1.5 cm superiorly, 2 cm laterally and 3 cm inferiorly based on pathology data and submucosal spread. However, wider excision of the primary tumor of hypopharynx inevitably compromised functional outcomes, causing impairment of respiration, speech, deglutition and thereby reduced patients’ quality of life. It was a challenge for head and neck surgeons to find a balance between safe surgical margin and minimal functional impairment.