NEAR-TOTAL LARYNGOPHARYNGECTOMY WITH PECTORALIS MAJOR MYOCUTANEOUS FLAP IN ADVANCED PYRIFORM CARCINOMA

Successful restoration of phonation, as well as swallowing in laryngop haryngeal surgery for patients with advanced pyriform carcinoma still remains a major challenge. In a five-year period, near-total laryngect omy operations were performed on 21 patients with laryngopharyngeal ca rcinoma. This report particularly emphasizes the value of near-total l aryngopharyngectomy with a pectoralis major myocutaneous flap for four extensive hypopharyngeal carcinoma cases (three of which were of pyri form origin). All four patients regained intelligible shunt speech and smooth swallowing. The follow-up period ranged from 19 to 44 months. They have had no recurrence of disease since surgery. The authors sugg est that an advanced pyriform carcinoma case, with a normal contralate ral hemilarynx and pyriform sinus, is a candidate for a near-total exc ision of the laryngopharynx.