Three-dimensional reconstruction of supraglottic structures after partial pharyngolaryngectomy for hypopharyngeal cancer

Minoru Sakuraba, Takayuki Asano, Shimpei Miyamoto, Ryuichi Hayashi, Masakazu Miyazaki, Toru Ugumori, Hiroyuki Daiko, Yoshihiro Kimata, Satoshi Ebihara, Kiyonori Harii

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: Larynx-preserving surgery is frequently performed for advanced hypopharyngeal cancer involving the larynx. However, reconstruction after partial pharyngolaryngectomy (PPL) remains a challenging problem because of the high risk of postoperative aspiration. In this report, we describe our new three-dimensional method for reconstructing supraglottic structures with a radial forearm flap. This is a retrospective analysis of 20 patients who underwent PPL for having hypopharyngeal cancer involving the larynx at our institution from 1996 to 2005. Methods: The resulting pharyngolaryngeal defects were reconstructed with radial forearm flaps in all patients. Three-dimensional structures were reconstructed with a single nylon suture, which was used to hoist the flap and ensures that the arytenoids and the aryepiglottic fold were of appropriate height. Results: Radial forearm flaps were transferred successfully in all but one case. Swallowing function was satisfactory in all patients, and decannulation could be performed in all but one patient. Postoperative conversational function in all patients was rated as excellent with Hirose's scoring system. Conclusions: Free jejunum transfer is the method of first choice for reconstruction of a defect after partial hypopharyngectomy. However, the complex supraglottic structures of the larynx are difficult to reconstruct with a free jejunal graft after PPL. In such cases, we perform three-dimensional reconstruction of the pharyngolaryngeal defect with a radial forearm flap and have achieved satisfactory postoperative function. We believe that our new procedure is a useful method for functional reconstruction after PPL.

Original languageEnglish
Pages (from-to)408-413
Number of pages6
JournalJapanese Journal of Clinical Oncology
Volume38
Issue number6
DOIs
Publication statusPublished - Jun 2008

Fingerprint

Hypopharyngeal Neoplasms
Forearm
Laryngeal Neoplasms
Larynx
Nylons
Jejunum
Deglutition
Sutures
Transplants

Keywords

  • Head and neck reconstruction
  • Hypopharyngeal cancer
  • Hypopharyngeal reconstruction
  • Partial pharyngolaryngectomy
  • Radial forearm flap

ASJC Scopus subject areas

  • Oncology

Cite this

Three-dimensional reconstruction of supraglottic structures after partial pharyngolaryngectomy for hypopharyngeal cancer. / Sakuraba, Minoru; Asano, Takayuki; Miyamoto, Shimpei; Hayashi, Ryuichi; Miyazaki, Masakazu; Ugumori, Toru; Daiko, Hiroyuki; Kimata, Yoshihiro; Ebihara, Satoshi; Harii, Kiyonori.

In: Japanese Journal of Clinical Oncology, Vol. 38, No. 6, 06.2008, p. 408-413.

Research output: Contribution to journalArticle

Sakuraba, M, Asano, T, Miyamoto, S, Hayashi, R, Miyazaki, M, Ugumori, T, Daiko, H, Kimata, Y, Ebihara, S & Harii, K 2008, 'Three-dimensional reconstruction of supraglottic structures after partial pharyngolaryngectomy for hypopharyngeal cancer', Japanese Journal of Clinical Oncology, vol. 38, no. 6, pp. 408-413. https://doi.org/10.1093/jjco/hyn047
Sakuraba, Minoru ; Asano, Takayuki ; Miyamoto, Shimpei ; Hayashi, Ryuichi ; Miyazaki, Masakazu ; Ugumori, Toru ; Daiko, Hiroyuki ; Kimata, Yoshihiro ; Ebihara, Satoshi ; Harii, Kiyonori. / Three-dimensional reconstruction of supraglottic structures after partial pharyngolaryngectomy for hypopharyngeal cancer. In: Japanese Journal of Clinical Oncology. 2008 ; Vol. 38, No. 6. pp. 408-413.
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AU - Asano, Takayuki

AU - Miyamoto, Shimpei

AU - Hayashi, Ryuichi

AU - Miyazaki, Masakazu

AU - Ugumori, Toru

AU - Daiko, Hiroyuki

AU - Kimata, Yoshihiro

AU - Ebihara, Satoshi

AU - Harii, Kiyonori

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N2 - Objective: Larynx-preserving surgery is frequently performed for advanced hypopharyngeal cancer involving the larynx. However, reconstruction after partial pharyngolaryngectomy (PPL) remains a challenging problem because of the high risk of postoperative aspiration. In this report, we describe our new three-dimensional method for reconstructing supraglottic structures with a radial forearm flap. This is a retrospective analysis of 20 patients who underwent PPL for having hypopharyngeal cancer involving the larynx at our institution from 1996 to 2005. Methods: The resulting pharyngolaryngeal defects were reconstructed with radial forearm flaps in all patients. Three-dimensional structures were reconstructed with a single nylon suture, which was used to hoist the flap and ensures that the arytenoids and the aryepiglottic fold were of appropriate height. Results: Radial forearm flaps were transferred successfully in all but one case. Swallowing function was satisfactory in all patients, and decannulation could be performed in all but one patient. Postoperative conversational function in all patients was rated as excellent with Hirose's scoring system. Conclusions: Free jejunum transfer is the method of first choice for reconstruction of a defect after partial hypopharyngectomy. However, the complex supraglottic structures of the larynx are difficult to reconstruct with a free jejunal graft after PPL. In such cases, we perform three-dimensional reconstruction of the pharyngolaryngeal defect with a radial forearm flap and have achieved satisfactory postoperative function. We believe that our new procedure is a useful method for functional reconstruction after PPL.

AB - Objective: Larynx-preserving surgery is frequently performed for advanced hypopharyngeal cancer involving the larynx. However, reconstruction after partial pharyngolaryngectomy (PPL) remains a challenging problem because of the high risk of postoperative aspiration. In this report, we describe our new three-dimensional method for reconstructing supraglottic structures with a radial forearm flap. This is a retrospective analysis of 20 patients who underwent PPL for having hypopharyngeal cancer involving the larynx at our institution from 1996 to 2005. Methods: The resulting pharyngolaryngeal defects were reconstructed with radial forearm flaps in all patients. Three-dimensional structures were reconstructed with a single nylon suture, which was used to hoist the flap and ensures that the arytenoids and the aryepiglottic fold were of appropriate height. Results: Radial forearm flaps were transferred successfully in all but one case. Swallowing function was satisfactory in all patients, and decannulation could be performed in all but one patient. Postoperative conversational function in all patients was rated as excellent with Hirose's scoring system. Conclusions: Free jejunum transfer is the method of first choice for reconstruction of a defect after partial hypopharyngectomy. However, the complex supraglottic structures of the larynx are difficult to reconstruct with a free jejunal graft after PPL. In such cases, we perform three-dimensional reconstruction of the pharyngolaryngeal defect with a radial forearm flap and have achieved satisfactory postoperative function. We believe that our new procedure is a useful method for functional reconstruction after PPL.

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KW - Partial pharyngolaryngectomy

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