Carcinoma of the hypopharynx: success and failure.
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Biomedical subjects
Publications and source records attributed to K Sako.
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Serum antibody titers to Epstein-Barr virus were significantly elevated in a group of twenty-three patients with nasopharyngeal carcinoma as compared with eighty-six patients with cancer of other sites in the head and neck and 222 age-matched controls. Our findings in this group of patients support the suggestion of an association between the Epstein-Barr virus and nasopharyngeal carcinoma.
1. A well defined group of patients have been studied. 2. Composite operation resulted in a 56 per cent five year disease-free survival rate. 3. Treatment of recurrent disease with irradiation increased the five year survival to 61 per cent. 4. Preoperative irradiation for squamous cell carcinoma of the intraoral cavity, stage III, is unwarranted unless this treatment plan can produce five year end results better than 61 per cent.
Patients who undergo extensive resection of the pharynx along with laryngectomy usually are not able to develop esophageal speech. Since 1971 we have been working on a method for speech rehabilitation for these patients, which utilizes sound from a reed powered by tracheal air outflow. The sound is led into the pharynx via a fistula. Ten patients have been so managed, and six are now using this method of communication with satisfactory results. Preliminary studies on one patient indicated that his speech quality was judged to be superior to that produced by an excellent esophageal speaker. Efforts are continuing to study further the acoustical and perceptual properties of this form of speech and to improve further the method.
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