Functional Analysis Of Hypopharynx Pyriform Sinus Carcinoma Laryngeal Function Sparing Surgery

Objective: To study the piriform sinus carcinoma reserved surgical resection of laryngeal function and repair a variety of restorative materials throat defects, surgery recovery method of operation, advantages and disadvantages of various repair methods and postoperative laryngeal function.Methods: Select 1992 to 2012 in our hospital treated 40 cases of laryngeal function reserved to swallow pyriform area cancer surgery patients. A retrospective analysis of all types of cancer swallow pyriform larynx preservation, larynx and pharynx reconstructive surgery to rebuild the pros and cons and functional recovery after throat, postoperative complications as well as survival after 5 years.Result:1、laryngeal functionThese 40 patients,(1) swallowing function: most patients with an average of 14 days after removal of the feeding tube, eating no cough 13 cases(32.50%), mild cough 23 cases(57.50%), moderate cough 4 cases(10.00%), after a week to a month of training were better.(2) respiratory function: 35 patients were pulled tracheal tube, the average time to extubation 60 d, extubation rate was 87.5%; 5 cases(12.5%) activity and breathing during sleep is not enough, failed extubation.(3) function :: pronunciation Pronunciation functions are restored, articulate 26 cases(65.00%), slightly hoarse pronunciation nine cases(22.50%), moderate hoarse 5 cases(12.5%).2、postoperative complications40 cases of patients with pyriform sinus fistula pharyngeal cancer concurrent four cases(10.00%), after topical dressing healed; aspiration 5 cases(12.50%), and the patients were immediately lifted row aspiration hazard; wound infection in 5 cases(12.50%), anti-infection after treatment with the dressing healed; lung infection in 3 patients(7.50%), the anti-infective therapy and suction treatment cured.3、the survival rateAfter 1 year survival rate was 87.50%, 65.00% after 3 years, compared with 50% after 5 years; the cause of death was lung metastases more, neck metastasis and liver metastases.Conclusion:1、In the complete removal of the exact premise of pyriform sinus carcinoma, the most normal laryngeal tissue retention, through the entire complex can be better functional recovery throat.2、Under laryngeal violations under greater pyriform cancer patients should be evaluated before surgery and surgical perfect look directly determine the guidance of lesions in order not to affect surgical patients after extubation select premise success rate and swallowing function.3、Preservation of laryngeal function during surgery pyriform sinus cancer should be divided into two areas, one for laryngeal tissues retain inviolate and shall be the entire complex, the second after resection of the primary tumor pyriform repair the defect.4、Pyriform reserved laryngeal cancer surgical procedures and a variety of repair materials, advantages and disadvantages, should be combined in clinical and pathological physiological condition of the patient, a comprehensive selection of personalized treatment options.