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

OBJECTIVE: Resection of local advanced hypopharyngeal cancer often results in laryngeal preservation impossible. Free flaps were used to reconstruct and to preserve functional larynx.

METHODS: 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.

RESULTS: 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.

CONCLUSION: Free flaps can be used to reconstruct a functional larynx in local advanced hypopharyngeal carcinoma, ensuring a better quality of life for patients.