FUNCTIONAL LONG-TERM AND ONCOLOGIC RESULT S FOLLOWING HEMIPHARYNGO-HEMILARYNGECTOMY (DESCRIBED BY LACCOURREYE) FOR HYPOPHARYNGEAL SQUAMOUS-CELL CARCINOMA

Background: Various techniques for the treatment of hypopharyngeal mal ignancies are used to achieve disease control while preserving larynge al function. Patients and Methods: This study details the long-term re sults of 22 patients (ages 39-80; average age 57 years) following hemi pharyngo-hemilaryngectomy (described by Laccourreye) for unilateral hy popharyngeal squamous cell carcinomas (G2-G3; T1-T4; N0-N3). Follow-up was 16-83 months (average 43) and included extensive speech and swall owing assessment. From 1989-1994 the procedure was performed in 26 pat ients. Two died within one year postoperatively, two were lost for fol low-up, and 22 were included in this study. Results: One patient devel oped recurrent disease with liver metastasis; two patients were succes sfully treated for recurrent disease. Two patients developed second pr imary tumors, while all others had no signs of recurrent disease. Four teen patients had no difficulties eating or drinking. Six patients cou ld only eat soft foods, and two patients required a gastrostomy feedin g tube. Nineteen patients had a useful but hoarse voice, and three pat ients had severe difficulties when communicating. Modulation of voice was decreased because the supraglottic structures (mainly false cord a nd scar tissue) were used for phonation. Eighteen patients were comple tely satisfied with their voice. The tracheotomy was closed in 18 pati ents within six months, while four patients required a tracheostoma fo r more than two years. Conclusions: These data show that function-pres erving surgical techniques can be successfully used in hypopharyngeal carcinomas even for patients with advanced disease. Useful functional results for swallowing, voice, and airway were achieved in most patien ts undergoing this procedure.