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Journal Article
[The reconstruction of the hypopharynx and the cervical esophagus (author's transl)].
Laryngologie, Rhinologie, Otologie 1979 August
Since 1973 16 reconstructions of the hypopharynx and cervical esophagus were performed. The restoration of swallowing was achieved in 7 cases after partial resection of the pharynx, 9 times after total laryngo-pharyngectomy and twice after laryngo-pharyngo-esophagectomy. The indication for surgery and criteria for the surgical methods to be applied are discussed. It is possible to combine the reconstruction of the pharynx with building up a neoglottis with Staffieri's technique for restoring voice function. As a one stage procedure to the hypopharynx and cervical esophagus after total laryngo-pharyngectomy the methods of Loré as well as the reconstructive techniques using regional flapes are useful. The larynx-hypopharynx-esophagusresection of Ong and Lee (1960) whould be prefered if the rumour involves the orifice of the esophagus, because an extensive submucosal growth of the carcinoma is to be expected. A two stage procedure is preferred when recurrences of cancer especially after x-ray therapy have to be treated, or a bilateral radical neck-dissection has to be done. This concept offers smaller risks and is finally also faster. A method is demonstrated using a bridge flap for the protection of the carotid artery and the reconstruction of the posterior wall of the pharynx using a deltopectoral flap for rebuilding the lateral and the anterior walls of the pharynx.
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