OBJECTIVE: To evaluate the clinical application of helical CT multiplanar reformation (MPR) three-dimensional reconstruction (3D) and virtual laryngoscopy (CTVL) in laryngeal and hypopharyngeal carcinoma. METHODS: Axi...OBJECTIVE: To evaluate the clinical application of helical CT multiplanar reformation (MPR) three-dimensional reconstruction (3D) and virtual laryngoscopy (CTVL) in laryngeal and hypopharyngeal carcinoma. METHODS: Axial helical CT scans were performed in 22 patients with laryngeal or hypopharyngeal carcinoma, along with MPR, 3D and CTVL. These results were compared with the findings of fiber optic laryngoscopy and surgery. RESULTS: Combining axial and MPR images, both the accuracy in preoperative tumor staging and the diagnosis of metastatic lymph nodes were 95%. MPR demonstrated more information about the extent of tumor than axial images in 23% cases; 3D image displayed clearly the extension of tumor, the vessels and airway from multiple views. The location, size and extent of tumors found in cranio-caudal CTVL corresponded well with that of laryngoscopy, and CTVL demonstrated the relationship between the tumor and vocal cords and anterior commissure by caudo-cranial approach, which was inaccessible to fiber optic laryngoscopy in 3 cases. CONCLUSIONS: Axial images of helical CT clearly demonstrate the location, size and extent of laryngeal and hypopharyngeal carcinoma, while MPR and 3D images are useful in displaying the three-dimensional images and anatomical relation of the tumor. CTVL can clearly display the mucosal surface structures of the larynx and hypopharynx and is a good complementary method of laryngoscopy.展开更多
Lymphatic metastasis(LM)emerges as an independent prognostic marker for hypopharyngeal squamous cell carcinoma(HSPSCC),chiefly contributing to treatment inefficacy.This study aimed to scrutinize the prognostic relevan...Lymphatic metastasis(LM)emerges as an independent prognostic marker for hypopharyngeal squamous cell carcinoma(HSPSCC),chiefly contributing to treatment inefficacy.This study aimed to scrutinize the prognostic relevance of HSP90AA1 and its potential regulatory mechanism of concerning LM in HPSCC.Methods:In a preceding investigation,HSP90AA1,a differential gene,was discovered through transcriptome sequencing of HPSCC tissues,considering both the presence and absence of LM.Validation of HSP90AA1 expression was accomplished via qRT-PCR,western-blotting(WB),and immunohistochemistry(IHC),while its prognostic significance was assessed employing Kaplan–Meier survival analysis(KMSA),log-rank test(LR),and Cox’s regression analysis(CRA).Bioinformatics techniques facilitated the prediction and analysis of its plausible mechanisms in LM,further substantiated by in vitro and in vivo experiments utilizing FaDu cell lines.Results:HSP90AA1 is substantially upregulated in HPSCC with LM and is identified as an independent prognostic risk determinant.The down-regulation of HSP90AA1 can achieve inhibition of tumor cell proliferation,migration and invasion.Both in vivo experiments and Bioinformatics exploration hint at promoting LM by Epithelial-mesenchymal transition(EMT),regulated by HSP90AA1.Conclusions:HSP90AA1,by controlling EMT,can foster LM in HPSCC.This finding sets the foundation for delving into new therapeutic targets for HPSCC.展开更多
OBJECTIVE: To study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma. METHODS: A retrospective review of 305 patients with malignant neoplasms of the hypop...OBJECTIVE: To study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma. METHODS: A retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage I, n = 6; stage II, n = 12; stage III, n = 82; stage IV, n = 205), the sites of origin were pyriform sinus (n = 234), postcricoid (n = 21), posterior pharyngeal wall (n = 35) and superior hypopharynx (n = 15). Of the 305 patients, 206 (67.54%, stage I, n = 6; stage II, n = 12; stage III, n = 65; stage IV, n = 123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage III, n = 17; stage IV, n = 82) had no laryngeal function preserved.All had 55-75 Gy radiotherapy according to their need. RESULTS: A total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage I), 71% (stage II), 58% (stage III), and 36% (stage IV). The 5-year survival of the laryngeal function preserved group was 48% (n = 66), the rate of complications 28% (n = 58) and the rate of residual tumor 5.8% (n = 12), compared with the no laryngeal function preserved group 37% (n = 20), 31.3% (n = 31), and 6% (n = 6) (P > 0.05). CONCLUSION: Only a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.展开更多
A 65-year-old man was admitted to our hospital following 6 months of dysphagia. At first, conventional endoscopy showed a reddish and depressed lesion in the stomach and an elevated lesion in the posterior wall of the...A 65-year-old man was admitted to our hospital following 6 months of dysphagia. At first, conventional endoscopy showed a reddish and depressed lesion in the stomach and an elevated lesion in the posterior wall of the hypopharynx. An endoscopic biopsy showed adenocarcinoma in the stomach, and squamous cell carcinoma in the hypopharynx. On the further examination, trans-nasal endoscopy with narrow band imaging (NBI) was performed. During the trumpet maneuver, a huge protruded lesion was observed and it reached to the orifice of the esophagus. Other superficial lesion located at left pyriform sinus was detected by NBI system as brownish area with brown dots. Furthermore, superficial esophageal cancer in the cervical esophagus was detected. Finally, 4 carcinomas in upper gastrointestinal tract were detected. Among them, the hypopharyngeal cancer was the most advanced (T3N0). The patient hoped to preserve his voice and swallowing function, endoscopic laryngo-pharyngeal surgery (ELPS) was performed for the hypopharyngeal cancer. Endoscopic mucosal resection (EMR) was performed for the esophageal cancer, and Endoscopic submucosal dissection (ESD) was performed for the gastric cancer. Under collaboration between a head and neck surgeon and an endoscopist, the tumor was resected en-bloc. The histopathological findings of hypopharyngeal cancer were squamous cell carcinoma, subeipthelial invasion, 29 × 28 × 4.2 mm. The others were diagnosed as mucosal cancers. The patient is currently alive with no recurrence at 28 months after the surgery;there is no stricture at the cervical esophagus. Endoscopic laryngopharyngeal surgery for the tumor of pharyngo-esophageal junction can provide a less invasive treatment.展开更多
BACKGROUND Hypopharyngeal cancer has the bleakest prognosis among head and neck cancers due to its extensive submucosal involvement,advanced tumor stage,and limited surgical reconstruction options.Its primary causes i...BACKGROUND Hypopharyngeal cancer has the bleakest prognosis among head and neck cancers due to its extensive submucosal involvement,advanced tumor stage,and limited surgical reconstruction options.Its primary causes include alcohol consumption,tobacco use,genetic predisposition,1`diet,and socioeconomic conditions.While squamous cell carcinoma(SCC)accounts for 95%of hypopharyngeal tumors,it remains a rare form,comprising only 3%-5%of all SCC cases in the head and neck region.Globally,Central and Eastern Europe have the highest incidence rates for males(3.9 per 100000)and the third highest for females(2.26 per 100000),underscoring the significance of this seemingly uncommon condition.In Romania,hypopharyngeal cancer ranked 24th in incidence rate,with 634 new cases in 2020.AIM To study the incidence,treatment and survival rates of hypopharyngeal tumor cases in a major ear,nose,throat(ENT)surgical center.METHODS A retrospective epidemiological clinical study was conducted on patients diagnosed and treated for hypopharyngeal cancer at the ENT department of"Carol Davila Central University Emergency Military Hospital"in Bucharest between January 2018 and August 2022.The study included 53 patients and was authorized by the Ethics Committee of Titu Maiorescu Doctoral School(Bucharest,Romania)and the Ethics Committee of Carol Davila Central University Emergency Military Hospital(Bucharest,Romania).Inclusion criteria required a positive histopathological diagnosis of hypopharyngeal cancer,tumor localization in the hypopharyngeal region,and informed consent for data usage.Exclusion criteria involved major psychiatric pathologies and disagreement for data usage.Diagnosis was based on ENT assessment,imaging reports,and laboratory data.Treatment methods were determined based on various factors.Additional tools,such as Adult Comorbidity Evaluation-27 and Karnofski Performance Status Scale,were used for risk assessment and functional capacity evaluation.Quality of life aspects were measured using the European Organisation for Rea展开更多
Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell ca...Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma （HPSCC） after neoadjuvant therapy in our institution.展开更多
Objective: To investigate the application value of magnetic resonance diffusion-weighted imaging (DWI) combined with conventional magnetic resonance imaging (MRI) in evaluating the efficacy of concurrent chemoradiothe...Objective: To investigate the application value of magnetic resonance diffusion-weighted imaging (DWI) combined with conventional magnetic resonance imaging (MRI) in evaluating the efficacy of concurrent chemoradiotherapy for hypopharyngeal carcinoma. Methods: A total of 20 patients with hypopharyngeal carcinoma diagnosed by pathological biopsy (who only received chemoradiotherapy without surgery) were collected. Before treatment, all patients underwent conventional MRI and DWI scanning, MRI characteristics of patients were analyzed, and maximum cross-sectional area of the tumor and average apparent diffusion coefficient (ADC) value were measured. One month after treatment, MRI was performed again to measure residual tumor area and ADC value, and the tumor remission rate was calculated. The changes in tumor ADC values before and after treatment were analyzed and their correlation with tumor remission rate was analyzed. The differences in ADC values and changes between complete response patients (CR group) and incomplete response patients (non-CR group) before and after treatment were analyzed. Results: The tumor area of 20 patients with hypopharyngeal cancer was 3.48 (0.93 - 5.6) cm2 before treatment and 0.24 (0 - 0.9) cm2 after treatment. There were 15 patients (15/20, 75%) in the CR group and 5 patients (5/20, 25.0%) in the non-CR group. The remission rate was 90.3% (6.0% - 100%). The average ADC value of the tumor before treatment was negatively correlated with the tumor remission rate after treatment (r = ?0.786, ?0.813, P Conclusion: The ADC value of tumor before treatment and the change of ADC value of tumor before and after treatment have a certain significance in evaluating the early remission rate of hypopharyngeal carcinoma after chemoradiotherapy.展开更多
BACKGROUND Generally,hemangiomas do not require surgical intervention;however,cases of large hemangiomas,potentially involving the throat and trachea,necessitate surgical therapy.Here,we present a case of hypopharynge...BACKGROUND Generally,hemangiomas do not require surgical intervention;however,cases of large hemangiomas,potentially involving the throat and trachea,necessitate surgical therapy.Here,we present a case of hypopharyngeal hemangioma in an adult that was successfully treated with neodymium-doped yttrium aluminum garnet(Nd-YAG)laser.CASE SUMMARY Laryngoscopic examination of a 61-year-old man demonstrated the presence of a large,submucosal vascular lesion that extended into the epiglottis,left arytenoid cartilage,lateral to the aryepiglottic fold,and pyriform sinus.The lesion was resected and photocoagulated with limited hemorrhage using Nd:YAG laser.The hypopharyngeal hemangioma was completely excised.The patient showed no recurrence of hypopharyngeal hemangioma during the 1.5-year follow-up period.CONCLUSION Laser therapy is one of the effective tools for treating hemangiomas with rapid,uncontrolled growth or in functional areas,with few side effects and complications.The present case of a male patient with a large hypopharyngeal hemangioma,treated with YAG laser,demonstrates the efficacy of laser photocoagulation in treating cases of hemangiomas,without the risk of bleeding or airway obstruction.The favorable postoperative outcomes demonstrated by our patient with Nd:YAG laser therapy indicate its consideration in the therapy of similar cases.展开更多
In order to evaluate the availability of the lateral horizontal laryngectomy and anaplasty of epiglottis to treat some patients with specific supraglottic carcinomas and hypopharyngeal carcinomas, 17 cases of laryngea...In order to evaluate the availability of the lateral horizontal laryngectomy and anaplasty of epiglottis to treat some patients with specific supraglottic carcinomas and hypopharyngeal carcinomas, 17 cases of laryngeal and hypopharyngeal carcinomas were retrospectively analyzed, whose tumors were located at the lateral margin of epiglottis, aryepiglottic fold, medial wall of piriform fossa and were treated by the lateral horizontal laryngectomy and anaplasty of epiglottis. The results showed that all cases took food by mouth in postoperative 9-14 days and subjected to decannulation in postoperative 9-15 days. Three cases had postoperative hoarse voice. The free-disease survival rate of 3 years was 71.4 % in 14 cases followed up after the first surgical therapy, and the overall free-disease survival rate of 3 years was 85.7 % after the second surgical therapy. It was concluded that the manipulations of the lateral horizontal laryngectomy and epiglottiplasty were simple. It could alleviate the postoperative symptoms of aspiration and bucking remarkably and shorten their postoperative recovery time, yet does not lower the survival rate of patients if laryngocarcinoma or hypopharyngeal carcinoma cases were properly selected.展开更多
Objective: To explore the feasibility of the submental island flap in the repair of hypopharyngeal defects.Methods: We collected wet specimens of fresh cadaveric heads from the Han Chinese adult population for applied...Objective: To explore the feasibility of the submental island flap in the repair of hypopharyngeal defects.Methods: We collected wet specimens of fresh cadaveric heads from the Han Chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps.Results: We found that the average length and width of the submental island flaps were (65.20 ± 11.69) mm and (46.70 ± 6.59) mm, respectively.The skin flap in all five patients survived after surgery, and tracheal tubes and gastric tubes were removed 7-36 days after surgery.Patients were followed up for 24-42 months, pharyngeal flaps grew well, and speech and swallowing functions were satisfactory.Conclusion: The submental island flap is a preferred material for the repair of hypopharyngeal defects after hypopharyngeal carcinoma resection, because of good blood supply, easy harvesting, and high survival rate.展开更多
We describe a procedure of slide pharyngo-esophagoplasty for restoration following ablation of hypopharyngeal cancer in a 99 year-old man. The elderly presented to our hospital with 2-month dysphagia, occasional blood...We describe a procedure of slide pharyngo-esophagoplasty for restoration following ablation of hypopharyngeal cancer in a 99 year-old man. The elderly presented to our hospital with 2-month dysphagia, occasional bloody salivation, and 2-day respiratory distress. To solve the problems of swallowing difficulty and dyspnea, he underwent laryngopharyngectomy, permanent tracheostomy, and slide pharyngo-esophagoplasty. The patient was uneventful after the restoration procedure.展开更多
<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Clinicopathological and biological features are associated with neck lymph n...<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Clinicopathological and biological features are associated with neck lymph node metastasis (LNM) of hypopharyngeal squamous cell carcinoma (HSCC). However, there is no complete nomogram combining multiple factors that can be used to accurately predict the neck LNM status for HSCC patients. </span><b><span style="font-family:Verdana;">Purpose:</span></b><span style="font-family:Verdana;"> To guide the selection of surgical methods and radiotherapy areas for hypopharyngeal cancer. In this study, a nomogram was developed to combine these risk factors to predict neck LNM and guide the treatment of HSCC. </span><b><span style="font-family:Verdana;">Material and Methods: </span></b><span style="font-family:Verdana;">This retrospective study included 117 patients (training cohort, 64 patients;trial cohort, 53 patients). Biological characteristics of HSCC patients were assessed using immunohistochemical staining, and data of patient age, gender, and preoperative computed tomography (CT) scan reports were collected. Significant risk factors in univariate analysis were further identified to be independent variables in multivariate logistic regression analysis, which were then incorporated in and presented with a nomogram by using the rms package in R software. Receiver operating characteristic (ROC) curves and calibration curves were used to validate the discrimination and accuracy in the training and validation cohorts, respectively, and clinical usefulness was verified in decision curve analysis curves. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">All variables with P-values < 0.2 in the univariate analysis were selected for multivariate logistic regression analysis to further identify independent risk factors for neck LNM. In multivariate logistic regression analysis, variables with P-values < 0.2 were identified as independent risk factors and then used to construct the nomo展开更多
The wasps of the genus Polistes have been considered the key to understanding the evolution of social behavior in Hymenoptera. Several studies have shown that the development of organized insect societies was accompan...The wasps of the genus Polistes have been considered the key to understanding the evolution of social behavior in Hymenoptera. Several studies have shown that the development of organized insect societies was accompanied by the evolution of structures like exocrine glands, which became specialized to perform specific functions. This article investigates the ultrastructural and cytochemical features of the hypopharyngeal glands of Polistes versicolor. These glands have been studied in depth in social bees, where they occur only in nurses and produce the royal jelly. Our results＇ revealed that these glands basically did not vary among individuals or between sexes. They are constituted by spherical cells, each with a large nucleus and well-developed rough endoplasmic reticulum. Secretion vesicles are abundant, but lipid droplets were not observed, indicating that these glands may not have a role in pheromone synthesis. Acid phosphatase was detected in lysosomes, and also flee in the cytosol, but did not seem to be related with cell death. Thus, our results suggest that the hypopharyngeal glands ofP. versicolor may not have a specialized social role, but could produce digestive enzymes.展开更多
Background:Organ preservation has long been a consideration in the treatment of supraglottic and hypopharyngeal carcin improve the quality of life(QOL).Definitive radiotherapy(DRT)with or without systematic treatment,...Background:Organ preservation has long been a consideration in the treatment of supraglottic and hypopharyngeal carcin improve the quality of life(QOL).Definitive radiotherapy(DRT)with or without systematic treatment,such as chemotherapy,is always the first choice to achieve improved QOL.This retrospective study focused on the survival differences between DRT and surgery followed by adjuvant radiotherapy(S+RT)in supraglottic and hypopharyngeal carcinoma.Methods:This study included adult patients with supraglottic or hypopharyngeal carcinoma undergoing single-modality treatment with either DRT or S+RT between January 2012 and August 2016.A total of 59 patients were identified,of whom 31 were treated with DRT,and 28 were treated with S+RT.In the 31 cases of DRT,23 cases were treated with concurrent chemoradiotherapy(CRT),one case was treated with DRT plus cetuximab,and seven cases were treated with DRT alone.Of the other 28 cases of S+RT,15 cases were treated with adjuvant concurrent CRT.Survival analysis was used to compare the overall survival(OS),local recurrence-free survival(LRFS)and distant metastasis-free survival(DMFS)between DRT and S+RT groups.Results:The median follow-up was 20 months(range,4-67 months).The patients of the two groups were similar with respect to mean age,original sites,and tumor stages.The 1-,2-,and 5-year OS rates were 80.6%,53.4%,and 24.7% for the DRT group and 85.7%,67.1%,and 24.7%for the S+RT group,respectively.There was no significant difference between the two groups(x^2=3.183,P=0.074).The 1-,2-,and 5-year LRFS and DMFS were 90.4%,61.7%,and 18.0%and 87.4%,49.2%,and 9.9%,respectively,and no statistical difference was observed between the two groups(LRFS:x^2=0.028,P=0.868;DMFS:x^2=3.347,P=0.067).No significant difference was found between the two groups in acute radiotoxicity.Conclusions:Without loss of laryngeal function,the survival of DRT is comparable to that of S+RT in supraglottic and hypopharyngeal carcinoma.展开更多
BACKGROUND Accurate delineation of the target area for patients with hypopharyngeal cancer is the key to achieving an ideal radiotherapy effect.Since computed tomography(CT)alone can no longer meet the treatment needs...BACKGROUND Accurate delineation of the target area for patients with hypopharyngeal cancer is the key to achieving an ideal radiotherapy effect.Since computed tomography(CT)alone can no longer meet the treatment needs,fusing CT images with magnetic resonance imaging(MRI)or positron emission tomography(PET)images can overcome the disadvantages of CT.Herein,we present a clinical case of hypopharyngeal cancer to delineate the tumor volume using combined MRI-CT and PET-CT fusion images to examine if they could accurately cover the tumor volume.CASE SUMMARY A 67-year-old male patient with hypopharyngeal carcinoma could not tolerate chemotherapy and surgery due to complicated health issues such as diabetic nephropathy and other underlying diseases.After multidisciplinary consultations,clinicians eventually agreed to undergo radiotherapy to control the progression of his tumor.He was examined by CT,MRI,and 18-fluorodeoxyglucose-PET for treatment planning,and CT images were fused with PET and MRI images while delineating tumor volume.CONCLUSION The image fusion of MRI-CT and PET-CT has both advantages and disadvantages.Compared with CT images alone,the combination of MRI-CT and PET-CT fusion images can precisely cover the gross tumor volume in hypopharyngeal carcinoma and avoid overestimation or incomplete coverage of tumor volume.展开更多
文摘OBJECTIVE: To evaluate the clinical application of helical CT multiplanar reformation (MPR) three-dimensional reconstruction (3D) and virtual laryngoscopy (CTVL) in laryngeal and hypopharyngeal carcinoma. METHODS: Axial helical CT scans were performed in 22 patients with laryngeal or hypopharyngeal carcinoma, along with MPR, 3D and CTVL. These results were compared with the findings of fiber optic laryngoscopy and surgery. RESULTS: Combining axial and MPR images, both the accuracy in preoperative tumor staging and the diagnosis of metastatic lymph nodes were 95%. MPR demonstrated more information about the extent of tumor than axial images in 23% cases; 3D image displayed clearly the extension of tumor, the vessels and airway from multiple views. The location, size and extent of tumors found in cranio-caudal CTVL corresponded well with that of laryngoscopy, and CTVL demonstrated the relationship between the tumor and vocal cords and anterior commissure by caudo-cranial approach, which was inaccessible to fiber optic laryngoscopy in 3 cases. CONCLUSIONS: Axial images of helical CT clearly demonstrate the location, size and extent of laryngeal and hypopharyngeal carcinoma, while MPR and 3D images are useful in displaying the three-dimensional images and anatomical relation of the tumor. CTVL can clearly display the mucosal surface structures of the larynx and hypopharynx and is a good complementary method of laryngoscopy.
基金supported by the National Natural Science Foundation of China(Grant No.82173303)Natural Science Foundation of Chongqing,China(Grant No.cstc2021ycjh-bgzxm0149).
文摘Lymphatic metastasis(LM)emerges as an independent prognostic marker for hypopharyngeal squamous cell carcinoma(HSPSCC),chiefly contributing to treatment inefficacy.This study aimed to scrutinize the prognostic relevance of HSP90AA1 and its potential regulatory mechanism of concerning LM in HPSCC.Methods:In a preceding investigation,HSP90AA1,a differential gene,was discovered through transcriptome sequencing of HPSCC tissues,considering both the presence and absence of LM.Validation of HSP90AA1 expression was accomplished via qRT-PCR,western-blotting(WB),and immunohistochemistry(IHC),while its prognostic significance was assessed employing Kaplan–Meier survival analysis(KMSA),log-rank test(LR),and Cox’s regression analysis(CRA).Bioinformatics techniques facilitated the prediction and analysis of its plausible mechanisms in LM,further substantiated by in vitro and in vivo experiments utilizing FaDu cell lines.Results:HSP90AA1 is substantially upregulated in HPSCC with LM and is identified as an independent prognostic risk determinant.The down-regulation of HSP90AA1 can achieve inhibition of tumor cell proliferation,migration and invasion.Both in vivo experiments and Bioinformatics exploration hint at promoting LM by Epithelial-mesenchymal transition(EMT),regulated by HSP90AA1.Conclusions:HSP90AA1,by controlling EMT,can foster LM in HPSCC.This finding sets the foundation for delving into new therapeutic targets for HPSCC.
文摘OBJECTIVE: To study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma. METHODS: A retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage I, n = 6; stage II, n = 12; stage III, n = 82; stage IV, n = 205), the sites of origin were pyriform sinus (n = 234), postcricoid (n = 21), posterior pharyngeal wall (n = 35) and superior hypopharynx (n = 15). Of the 305 patients, 206 (67.54%, stage I, n = 6; stage II, n = 12; stage III, n = 65; stage IV, n = 123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage III, n = 17; stage IV, n = 82) had no laryngeal function preserved.All had 55-75 Gy radiotherapy according to their need. RESULTS: A total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage I), 71% (stage II), 58% (stage III), and 36% (stage IV). The 5-year survival of the laryngeal function preserved group was 48% (n = 66), the rate of complications 28% (n = 58) and the rate of residual tumor 5.8% (n = 12), compared with the no laryngeal function preserved group 37% (n = 20), 31.3% (n = 31), and 6% (n = 6) (P > 0.05). CONCLUSION: Only a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.
文摘A 65-year-old man was admitted to our hospital following 6 months of dysphagia. At first, conventional endoscopy showed a reddish and depressed lesion in the stomach and an elevated lesion in the posterior wall of the hypopharynx. An endoscopic biopsy showed adenocarcinoma in the stomach, and squamous cell carcinoma in the hypopharynx. On the further examination, trans-nasal endoscopy with narrow band imaging (NBI) was performed. During the trumpet maneuver, a huge protruded lesion was observed and it reached to the orifice of the esophagus. Other superficial lesion located at left pyriform sinus was detected by NBI system as brownish area with brown dots. Furthermore, superficial esophageal cancer in the cervical esophagus was detected. Finally, 4 carcinomas in upper gastrointestinal tract were detected. Among them, the hypopharyngeal cancer was the most advanced (T3N0). The patient hoped to preserve his voice and swallowing function, endoscopic laryngo-pharyngeal surgery (ELPS) was performed for the hypopharyngeal cancer. Endoscopic mucosal resection (EMR) was performed for the esophageal cancer, and Endoscopic submucosal dissection (ESD) was performed for the gastric cancer. Under collaboration between a head and neck surgeon and an endoscopist, the tumor was resected en-bloc. The histopathological findings of hypopharyngeal cancer were squamous cell carcinoma, subeipthelial invasion, 29 × 28 × 4.2 mm. The others were diagnosed as mucosal cancers. The patient is currently alive with no recurrence at 28 months after the surgery;there is no stricture at the cervical esophagus. Endoscopic laryngopharyngeal surgery for the tumor of pharyngo-esophageal junction can provide a less invasive treatment.
文摘BACKGROUND Hypopharyngeal cancer has the bleakest prognosis among head and neck cancers due to its extensive submucosal involvement,advanced tumor stage,and limited surgical reconstruction options.Its primary causes include alcohol consumption,tobacco use,genetic predisposition,1`diet,and socioeconomic conditions.While squamous cell carcinoma(SCC)accounts for 95%of hypopharyngeal tumors,it remains a rare form,comprising only 3%-5%of all SCC cases in the head and neck region.Globally,Central and Eastern Europe have the highest incidence rates for males(3.9 per 100000)and the third highest for females(2.26 per 100000),underscoring the significance of this seemingly uncommon condition.In Romania,hypopharyngeal cancer ranked 24th in incidence rate,with 634 new cases in 2020.AIM To study the incidence,treatment and survival rates of hypopharyngeal tumor cases in a major ear,nose,throat(ENT)surgical center.METHODS A retrospective epidemiological clinical study was conducted on patients diagnosed and treated for hypopharyngeal cancer at the ENT department of"Carol Davila Central University Emergency Military Hospital"in Bucharest between January 2018 and August 2022.The study included 53 patients and was authorized by the Ethics Committee of Titu Maiorescu Doctoral School(Bucharest,Romania)and the Ethics Committee of Carol Davila Central University Emergency Military Hospital(Bucharest,Romania).Inclusion criteria required a positive histopathological diagnosis of hypopharyngeal cancer,tumor localization in the hypopharyngeal region,and informed consent for data usage.Exclusion criteria involved major psychiatric pathologies and disagreement for data usage.Diagnosis was based on ENT assessment,imaging reports,and laboratory data.Treatment methods were determined based on various factors.Additional tools,such as Adult Comorbidity Evaluation-27 and Karnofski Performance Status Scale,were used for risk assessment and functional capacity evaluation.Quality of life aspects were measured using the European Organisation for Rea
文摘Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma （HPSCC） after neoadjuvant therapy in our institution.
文摘Objective: To investigate the application value of magnetic resonance diffusion-weighted imaging (DWI) combined with conventional magnetic resonance imaging (MRI) in evaluating the efficacy of concurrent chemoradiotherapy for hypopharyngeal carcinoma. Methods: A total of 20 patients with hypopharyngeal carcinoma diagnosed by pathological biopsy (who only received chemoradiotherapy without surgery) were collected. Before treatment, all patients underwent conventional MRI and DWI scanning, MRI characteristics of patients were analyzed, and maximum cross-sectional area of the tumor and average apparent diffusion coefficient (ADC) value were measured. One month after treatment, MRI was performed again to measure residual tumor area and ADC value, and the tumor remission rate was calculated. The changes in tumor ADC values before and after treatment were analyzed and their correlation with tumor remission rate was analyzed. The differences in ADC values and changes between complete response patients (CR group) and incomplete response patients (non-CR group) before and after treatment were analyzed. Results: The tumor area of 20 patients with hypopharyngeal cancer was 3.48 (0.93 - 5.6) cm2 before treatment and 0.24 (0 - 0.9) cm2 after treatment. There were 15 patients (15/20, 75%) in the CR group and 5 patients (5/20, 25.0%) in the non-CR group. The remission rate was 90.3% (6.0% - 100%). The average ADC value of the tumor before treatment was negatively correlated with the tumor remission rate after treatment (r = ?0.786, ?0.813, P Conclusion: The ADC value of tumor before treatment and the change of ADC value of tumor before and after treatment have a certain significance in evaluating the early remission rate of hypopharyngeal carcinoma after chemoradiotherapy.
基金Supported by the Jinshan Hospital Qihang Plan,No.2018-JSYYQH-02
文摘BACKGROUND Generally,hemangiomas do not require surgical intervention;however,cases of large hemangiomas,potentially involving the throat and trachea,necessitate surgical therapy.Here,we present a case of hypopharyngeal hemangioma in an adult that was successfully treated with neodymium-doped yttrium aluminum garnet(Nd-YAG)laser.CASE SUMMARY Laryngoscopic examination of a 61-year-old man demonstrated the presence of a large,submucosal vascular lesion that extended into the epiglottis,left arytenoid cartilage,lateral to the aryepiglottic fold,and pyriform sinus.The lesion was resected and photocoagulated with limited hemorrhage using Nd:YAG laser.The hypopharyngeal hemangioma was completely excised.The patient showed no recurrence of hypopharyngeal hemangioma during the 1.5-year follow-up period.CONCLUSION Laser therapy is one of the effective tools for treating hemangiomas with rapid,uncontrolled growth or in functional areas,with few side effects and complications.The present case of a male patient with a large hypopharyngeal hemangioma,treated with YAG laser,demonstrates the efficacy of laser photocoagulation in treating cases of hemangiomas,without the risk of bleeding or airway obstruction.The favorable postoperative outcomes demonstrated by our patient with Nd:YAG laser therapy indicate its consideration in the therapy of similar cases.
文摘In order to evaluate the availability of the lateral horizontal laryngectomy and anaplasty of epiglottis to treat some patients with specific supraglottic carcinomas and hypopharyngeal carcinomas, 17 cases of laryngeal and hypopharyngeal carcinomas were retrospectively analyzed, whose tumors were located at the lateral margin of epiglottis, aryepiglottic fold, medial wall of piriform fossa and were treated by the lateral horizontal laryngectomy and anaplasty of epiglottis. The results showed that all cases took food by mouth in postoperative 9-14 days and subjected to decannulation in postoperative 9-15 days. Three cases had postoperative hoarse voice. The free-disease survival rate of 3 years was 71.4 % in 14 cases followed up after the first surgical therapy, and the overall free-disease survival rate of 3 years was 85.7 % after the second surgical therapy. It was concluded that the manipulations of the lateral horizontal laryngectomy and epiglottiplasty were simple. It could alleviate the postoperative symptoms of aspiration and bucking remarkably and shorten their postoperative recovery time, yet does not lower the survival rate of patients if laryngocarcinoma or hypopharyngeal carcinoma cases were properly selected.
文摘Objective: To explore the feasibility of the submental island flap in the repair of hypopharyngeal defects.Methods: We collected wet specimens of fresh cadaveric heads from the Han Chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps.Results: We found that the average length and width of the submental island flaps were (65.20 ± 11.69) mm and (46.70 ± 6.59) mm, respectively.The skin flap in all five patients survived after surgery, and tracheal tubes and gastric tubes were removed 7-36 days after surgery.Patients were followed up for 24-42 months, pharyngeal flaps grew well, and speech and swallowing functions were satisfactory.Conclusion: The submental island flap is a preferred material for the repair of hypopharyngeal defects after hypopharyngeal carcinoma resection, because of good blood supply, easy harvesting, and high survival rate.
文摘We describe a procedure of slide pharyngo-esophagoplasty for restoration following ablation of hypopharyngeal cancer in a 99 year-old man. The elderly presented to our hospital with 2-month dysphagia, occasional bloody salivation, and 2-day respiratory distress. To solve the problems of swallowing difficulty and dyspnea, he underwent laryngopharyngectomy, permanent tracheostomy, and slide pharyngo-esophagoplasty. The patient was uneventful after the restoration procedure.
文摘<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Clinicopathological and biological features are associated with neck lymph node metastasis (LNM) of hypopharyngeal squamous cell carcinoma (HSCC). However, there is no complete nomogram combining multiple factors that can be used to accurately predict the neck LNM status for HSCC patients. </span><b><span style="font-family:Verdana;">Purpose:</span></b><span style="font-family:Verdana;"> To guide the selection of surgical methods and radiotherapy areas for hypopharyngeal cancer. In this study, a nomogram was developed to combine these risk factors to predict neck LNM and guide the treatment of HSCC. </span><b><span style="font-family:Verdana;">Material and Methods: </span></b><span style="font-family:Verdana;">This retrospective study included 117 patients (training cohort, 64 patients;trial cohort, 53 patients). Biological characteristics of HSCC patients were assessed using immunohistochemical staining, and data of patient age, gender, and preoperative computed tomography (CT) scan reports were collected. Significant risk factors in univariate analysis were further identified to be independent variables in multivariate logistic regression analysis, which were then incorporated in and presented with a nomogram by using the rms package in R software. Receiver operating characteristic (ROC) curves and calibration curves were used to validate the discrimination and accuracy in the training and validation cohorts, respectively, and clinical usefulness was verified in decision curve analysis curves. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">All variables with P-values < 0.2 in the univariate analysis were selected for multivariate logistic regression analysis to further identify independent risk factors for neck LNM. In multivariate logistic regression analysis, variables with P-values < 0.2 were identified as independent risk factors and then used to construct the nomo
文摘The wasps of the genus Polistes have been considered the key to understanding the evolution of social behavior in Hymenoptera. Several studies have shown that the development of organized insect societies was accompanied by the evolution of structures like exocrine glands, which became specialized to perform specific functions. This article investigates the ultrastructural and cytochemical features of the hypopharyngeal glands of Polistes versicolor. These glands have been studied in depth in social bees, where they occur only in nurses and produce the royal jelly. Our results＇ revealed that these glands basically did not vary among individuals or between sexes. They are constituted by spherical cells, each with a large nucleus and well-developed rough endoplasmic reticulum. Secretion vesicles are abundant, but lipid droplets were not observed, indicating that these glands may not have a role in pheromone synthesis. Acid phosphatase was detected in lysosomes, and also flee in the cytosol, but did not seem to be related with cell death. Thus, our results suggest that the hypopharyngeal glands ofP. versicolor may not have a specialized social role, but could produce digestive enzymes.
文摘Background:Organ preservation has long been a consideration in the treatment of supraglottic and hypopharyngeal carcin improve the quality of life(QOL).Definitive radiotherapy(DRT)with or without systematic treatment,such as chemotherapy,is always the first choice to achieve improved QOL.This retrospective study focused on the survival differences between DRT and surgery followed by adjuvant radiotherapy(S+RT)in supraglottic and hypopharyngeal carcinoma.Methods:This study included adult patients with supraglottic or hypopharyngeal carcinoma undergoing single-modality treatment with either DRT or S+RT between January 2012 and August 2016.A total of 59 patients were identified,of whom 31 were treated with DRT,and 28 were treated with S+RT.In the 31 cases of DRT,23 cases were treated with concurrent chemoradiotherapy(CRT),one case was treated with DRT plus cetuximab,and seven cases were treated with DRT alone.Of the other 28 cases of S+RT,15 cases were treated with adjuvant concurrent CRT.Survival analysis was used to compare the overall survival(OS),local recurrence-free survival(LRFS)and distant metastasis-free survival(DMFS)between DRT and S+RT groups.Results:The median follow-up was 20 months(range,4-67 months).The patients of the two groups were similar with respect to mean age,original sites,and tumor stages.The 1-,2-,and 5-year OS rates were 80.6%,53.4%,and 24.7% for the DRT group and 85.7%,67.1%,and 24.7%for the S+RT group,respectively.There was no significant difference between the two groups(x^2=3.183,P=0.074).The 1-,2-,and 5-year LRFS and DMFS were 90.4%,61.7%,and 18.0%and 87.4%,49.2%,and 9.9%,respectively,and no statistical difference was observed between the two groups(LRFS:x^2=0.028,P=0.868;DMFS:x^2=3.347,P=0.067).No significant difference was found between the two groups in acute radiotoxicity.Conclusions:Without loss of laryngeal function,the survival of DRT is comparable to that of S+RT in supraglottic and hypopharyngeal carcinoma.
文摘BACKGROUND Accurate delineation of the target area for patients with hypopharyngeal cancer is the key to achieving an ideal radiotherapy effect.Since computed tomography(CT)alone can no longer meet the treatment needs,fusing CT images with magnetic resonance imaging(MRI)or positron emission tomography(PET)images can overcome the disadvantages of CT.Herein,we present a clinical case of hypopharyngeal cancer to delineate the tumor volume using combined MRI-CT and PET-CT fusion images to examine if they could accurately cover the tumor volume.CASE SUMMARY A 67-year-old male patient with hypopharyngeal carcinoma could not tolerate chemotherapy and surgery due to complicated health issues such as diabetic nephropathy and other underlying diseases.After multidisciplinary consultations,clinicians eventually agreed to undergo radiotherapy to control the progression of his tumor.He was examined by CT,MRI,and 18-fluorodeoxyglucose-PET for treatment planning,and CT images were fused with PET and MRI images while delineating tumor volume.CONCLUSION The image fusion of MRI-CT and PET-CT has both advantages and disadvantages.Compared with CT images alone,the combination of MRI-CT and PET-CT fusion images can precisely cover the gross tumor volume in hypopharyngeal carcinoma and avoid overestimation or incomplete coverage of tumor volume.
