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At least 19 recordsLinked to original sources
PubMed1979

[Morphological changes in the hypopharynx-esophageal region following laryngectomy. II. Median-sagittal infolding above the ventral aspect of the hypopharynx-esophageal region (author's transl)].

This paper deals with the morphological findings in the hypopharynx-esophageal region of two patients following laryngectomy. In these patients we found a median-sagittal infolding, situated above the ventral aspect of the hypopharynx-esophageal region. This infolding was due to the surgical closure of the ventral wall of the esophagus, following laryngectomy. Histological examination revealed a hernia-like prolapse of the tunica mücosa, m. mucosae and tela submucosa with numerous proliferated macrophages and blood vessels, but no lymphatics. These macrophages are concerned with the removal of an edema, which, however, is only imperfectly removed and finally turns out into a fibrous tissue. The functional meaning of this infolding is not yet clear, but it seems intimately related to the altered function of the hypopharynx-esophageal region following laryngectomy.

Aged↗
PubMed1983

Superficial extending carcinoma of the hypopharynx: report of 26 cases of an underestimated carcinoma.

Advanced ulcerating and infiltration tumors are commonly found in the hypopharynx, whereas early well-defined lesions are rarely diagnosed. The pathologic reports of 242 uniformly studied surgical specimens after total pharyngolaryngectomy for cancer of the hypopharynx were reviewed. The histologic analysis of 26 cancers (10.7%), which were recorded as having an entire or predominant superficial type of spreading, demonstrated that also in the hypopharynx a "superficial extending carcinoma" (SEC) may occur. SEC of hypopharynx was pathologically defined as a poorly or moderately differentiated squamous cell carcinoma, generally located in the pyriform sinus, which spreads superficially. It was limited to the mucosa (2.9%), but more frequently early infiltrated the underlying muscle or gland structures (6.2%), regardless of the presence of lymph node metastases or lymph vessels invasion. Although the concept that SEC of the hypopharynx may be an expression of a generalized disease of the mucosa must be carefully considered in surgical management, it appeared that this carcinoma in its "pure" intramucosal form may be associated with a good prognosis and a long survival.

Adult↗
PubMed1996

5-Fluorouracil metabolism and cytotoxicity after pre-treatment with methotrexate or thymidine in human hypopharynx and colon carcinoma xenografts: a 19F-nuclear magnetic resonance spectroscopy study in vivo.

The metabolism of 5-fluorouracil (5-FU) was monitored non-invasively in two xenografts, a hypopharynx carcinoma and a colon carcinoma (CSM) by 19F-magnetic resonance spectroscopy following an i.v. bolus injection of 130 mg kg-1 5-FU. Both the level of fluoronucleotides (FNuc) and the tumor growth delay were significantly higher in the CSM colon carcinoma than in the hypopharynx carcinoma (both parameters, P < 0.001). Administration of 100 mg kg-1 methotrexate (MTX) at 15 h before treatment with 5-FU caused a significantly increased conversion of 5-FU to FNuc in both tumors (P < 0.05) as compared with the application of 5-FU alone. However, only in the CSM tumor was a significantly increased growth delay (P < 0.01) observed. Pre-treatment of both xenografts with 400 mg kg-1 thymidine enhanced the conversion of 5-FU to FNuc in both tumors. In the CSM tumour this treatment modality caused a significantly (P < 0.05) higher growth delay as compared with the results obtained with 5-FU alone, whereas in the hypopharynx carcinoma the additional application of thymidine caused no significant change in tumor growth. It is known that both thymidine and MTX can reduce the DNA-directed cytotoxicity of 5-FU, whereas the RNA-directed cytotoxicity is increased. It is concluded that the DNA-mediated toxicity may be more important in the hypopharynx carcinoma than in the CSM colon carcinoma. As a consequence, pre-treatment with MTX or thymidine enhances FNuc formation, although only in the CSM carcinoma is there an increased tumor growth delay. Thus, in the hypopharynx carcinoma the measurement of FNuc did not serve as a predictor for the treatment efficacy of the combined treatment modality. Pre-treatment with MTX did not influence the catabolism of 5-FU, whereas thymidine actually prolonged the half-life of 5-FU without alpha-fluoro-beta-alanine becoming detectable.

Animals↗
PubMed2004

Removal of fish bones in the oropharynx and hypopharynx under video laryngeal telescopic guidance.

OBJECTIVE: The study goal was to present the technique and results of removal of fish bones in the oropharynx and hypopharynx under video laryngeal telescopic guidance. Study design and set From January 2001 to December 2002, a total of 27 patients with fish bones lodged in the oropharynx and hypopharynx were studied at the ENT Department of Taipei Medical University Hospital. RESULTS: All fish bones were removed smoothly without necessitating further procedures at the time of the initial clinical examination and had an uneventful clinical course. CONCLUSION: Removal of fish bones lodged at the tongue base, vallecula, and hypopharynx under video laryngeal telescopic guidance has the advantages of good illumination, clear visualization, and precise extraction.The technique has also proven to be efficient, safe, well tolerated, and with low morbidity. SIGNIFICANCE: Removal of the fish bones from difficult areas in oropharynx and hypopharynx with this technique can reduce the use of direct laryngoscope under general anesthesia.

Adult↗
PubMed2001

Delayed regional metastases, distant metastases, and second primary malignancies in squamous cell carcinomas of the larynx and hypopharynx.

OBJECTIVE: To determine the impact of delayed regional metastases, distant metastases, and second primary tumors on the therapeutic outcomes in squamous cell carcinomas of the larynx and hypopharynx. STUDY DESIGN: Chart review and statistical analysis. METHODS: A retrospective tumor registry analysis was made of patients with squamous cell carcinomas of the larynx and hypopharynx who were treated with curative intent in the Department of Otolaryngology-Head and Neck Surgery and the Radiation Oncology Center of the Washington University School of Medicine (St. Louis, MO) between January 1971 and December 1991 and developed delayed regional metastases (2 y after treatment), distant metastases, and second primary malignancies. RESULTS: In 2550 patients, the mean age (59.8 y), sex (8.5 male patients and 1 female patient), and tumor differentiation did not affect the incidence of delayed distant, regional, or second primary malignancies. The overall incidence of delayed regional metastases was 12.4% (317/2550 patients); distant metastases, 8.5% (217/2550); and second primary tumors, 8.9% (228/2550), with a 5-year disease-specific survival of 41%, 6.4%, and 35%, respectively. Second primary malignancies were not statistically related to the origin of the primary tumor, tumor staging, or delayed regional and distant metastases (P =.98). Delayed regional metastases and distant metastases were related to advanced primary disease (T4 stage), lymph node metastases (node positive [N+]), tumor location (hypopharynx), and locoregional tumor recurrence (P < or =.028). Advanced regional metastases at initial diagnosis (N2 and N3 disease) increased the incidence of delayed and distant metastases threefold (P =.017). These two metastatic parameters were significantly greater in hypopharyngeal tumors than in laryngeal tumors (P =.037). The incidences of delayed regional metastases by anatomical location of the primary tumor were as follows: glottic, 4.4%; supraglottic, 16%; subglottic, 11.5%; aryepiglottic fold, 21.9%; pyriform sinus, 31.1%; and posterior hypopharyngeal wall, 18.5%. The incidences of distant metastases were as follows: glottic, 4%; supraglottic, 3.7%; subglottic, 14%; aryepiglottic fold, 16%; pyriform fossa, 17.2%; and posterior hypopharyngeal wall, 17.6%. Seventeen hypopharyngeal tumors (2%) presented with M1 disease. Delayed regional metastases to the ipsilateral treated neck had a significantly worse survival prognosis than delayed metastases to the contralateral nontreated neck (P =.001). CONCLUSIONS: Conclusions are as follows: 1) The incidence of second primary tumors is independent from the primary tumor staging and distant and delayed regional metastases. The highest incidence occurred in patient groups with the highest disease-free survival rates (P =.0378). 2) Highest incidence of delayed and distant metastases occurred in hypopharyngeal tumors and was three times greater than in laryngeal cancers (P =.028). 3) Salvage therapeutic rates were poor for delayed metastases to the ipsilateral treated nodes and distant metastases as compared with contralateral neck metastases and second primary tumors (P =.001). 4) Delayed and distant lymph node metastases were significantly higher in advanced primary disease (T4 stage), locoregional recurrences, and regional disease (N2 and N3) (P =.028) in both the larynx and hypopharynx. 5) The higher incidence of delayed and distant metastatic disease was related to more advanced initial tumor presentation in hypopharyngeal cancer as compared with laryngeal cancer (P =.039). 6) Incidence of distant metastases was greatest between 1.5 and 6 years after initial treatment with a mean incidence being less than or equal to 3.2 years.

Adult↗
PubMed1998

[Clinical investigation of lymph node metastasis in carcinoma of the hypopharynx].

Carcinoma of the hypopharynx has a great tendency to metastasize to the neck. In addition it often metastasizes to the upper retropharyngeal lymph nodes (Rouviere's lymph nodes) and to the paratracheal lymph nodes. In this study, in order to determine the pattern of lymph node metastasis, 112 patients with carcinoma of the hypopharynx who had undergone bilateral radical neck dissection, bilateral paratracheal dissection, bilateral dissection of retropharyngeal nodes as an initial treatment between January 1982 and June 1997 in the Kurume University Hospital, were retrospectively reviewed in detail. Special attention was paid to retropharyngeal nodes and paratracheal lymph nodes. In N0 cases neck metastases were seen in more than one-quarter of the patients. Metastasis to retropharyngeal lymph nodes and to the paratracheal lymph nodes was seen in 5.4% and 12.5% of the patients, respectively. The frequency of metastasis to paratracheal lymph nodes had a significantly close relationship with that to the upper and lower jugular lymph nodes. The frequency of metastasis to retropharyngeal lymph nodes also had significantly close relationship with that to paratracheal lymph nodes, while having no relationship with that to other neck lymph nodes. These results suggest the following: 1) In patients with T1 or T2 PS type carcinoma of the hypopharynx, in which the lesion is confined unilaterally and is presumed to have been successfully treated by laser surgery prior to radiotherapy, unilateral neck dissection alone will be sufficient. In all the other patients with carcinoma of the hypopharynx bilateral neck dissection must be performed. 2) In all patients retropharyngeal lymph nodes and paratracheal lymph nodes should be dissected as much as possible and postoperative irradiation to both areas will be necessary.

Female↗
PubMed2002

[Jejunal free flap for reconstruction of the hypopharynx].

Squamous cell carcinoma of the hypopharynx is an aggressive tumor with a bad prognosis. When the tumor is resected it is necessary to reconstruct the hypopharynx and the esophagus. Today, reconstruction with a jejunal free flap is considered to be the preferred option. We present a series of five patients with squamous cell carcinoma of the hypopharynx operated on at the Department of Otolaryngology in the Rabin Medical Center. All underwent total laryngopharyngectomy and reconstruction with a jejunal free flap. Three patients resumed total enteral nutrition about two weeks post surgery. One patient suffered from a pharyngocutaneous fistula and continued parenteral nutrition via a jejunostomy. One patient suffered from necrosis of the flap, which necessitated its resection. Despite the morbidity which follows surgery of the hypopharynx and despite the low cure rates, a successful reconstruction with jejunal free flap enables the resumption of oral nutrition and improvement in the patients quality of life.

Adult↗
PubMed2006

[The treatment for hypopharynx stenosis using platysma pedicle flap].

OBJECTIVE: To evaluate the possibility and reliability of platysma pedicle flap transfer in the correction of hypopharynx stenosis,and delineate the operation skills and clinical results. METHOD: Ten patients with hypopharynx stenosis underwent hypopharynx reconstruction using platysma pedicle flap. RESULT: Nine of these patients had been decannulated successfully with good airway patency, good pronunciation and a good swallow. CONCLUSION: Platysma pedicle flap transfer was a single stage reconstruction, relatively simple procedure and less complication that can restore an adequate airway and a good swallow. The results indicate that the platysma pedicle flap is an ideal transplant for hypopharynx reconstruction. This method is simple, safe and reliable.

Adolescent↗
PubMed2005

Induction chemotherapy with cisplatin and 5-fluorouracil followed by chemoradiotherapy or radiotherapy alone in the treatment of locoregionally advanced resectable cancers of the larynx and hypopharynx: results of single-center study of 45 patients.

BACKGROUND: Induction chemotherapy with cisplatin and fluorouracil and radiotherapy is an effective alternative to surgery in patients with carcinoma of the larynx and hypopharynx who are treated for organ preservation. METHODS: We designed a protocol to evaluate the possibility of organ preservation in patients with advanced, resectable carcinoma of the larynx and hypopharynx. Forty-five eligible patients who were followed up between April 1999 and May 2001 were enrolled. Initially, these patients were treated with two cycles of induction chemotherapy consisting of cisplatin, 20 mg/m2/day on days 1 to 5, and 5-fluorouracil, 600 mg/m2/day by continuous infusion on days 1 to 5. Patients who had a complete response to chemotherapy were treated with definitive radiotherapy; patients who had a partial response to chemotherapy were treated with chemoradiotherapy. Cisplatin, 35 mg/m2/week, was introduced throughout the duration of radiotherapy. Patients who had no response or progressive disease underwent surgery with postoperative radiotherapy. Patients with N2 or N3 positive lymph nodes underwent neck dissection after the treatment. RESULTS: The mean age was 56.6 years (range, 34-75 years). The overall response rate to induction chemotherapy was 71.1%, with a 17.8% complete response rate and 53.3% partial response rate. With a median follow-up of 13.7 months, 23 (51.1%) of all patients and 63.3% of surviving patients have had a preservation of the larynx or hypopharynx and remain disease free. The most common toxicities were nausea and vomiting and mucositis. CONCLUSION: Organ preservation, with multimodality treatment, may be achievable in some of the patients with resectable, advanced larynx or hypopharynx cancers without apparent compromise of survival.

Adult↗
PubMed1992

View from beneath: pathology in focus. Synovial sarcoma of hypopharynx.

Synovial sarcoma of the hypopharynx is a rare neoplasm. To date only 23 cases of synovial sarcoma of the hypopharynx have been reported in the literature. An additional case in an 18-year-old male is presented. This is the first case of synovial sarcoma in the hypopharynx to be reported in Singapore. The presentation was that of a mass in the hypopharynx; progressive dysphagia, intermittent hoarseness and gradual airway compromise. A CT scan was valuable in determining the site of origin and extent of the lesion. Histopathology was diagnostic. Treatment comprised of wide surgical excision of the tumour and post-operative radiotherapy.

Adolescent↗
PubMed1996

[Systematic analysis of cervical lymph node metastasis of larynx and hypopharynx carcinomas--a clinical computerized tomography study with special reference to extension of the primary tumor].

PURPOSE: To assess the incidence and patterns of cervical lymph node metastases in laryngeal and hypopharyngeal carcinomas according to the location, extension, and relation of the primary tumor to the parapharyngeal compartments and tissues arising from different embryological structures as branchial arches and somites. PATIENTS AND METHODS: The findings of clinical and CT examinations of 230 patients with histological evidence of laryngeal and hypopharyngeal carcinoma (44 T1-, 33 T2-, 41 T3-, 112 T4-carcinomas with lymph node involvement in 116 cases) were evaluated retrospectively. Local tumor spread and relation of the primary to the parapharyngeal compartments and to tissues arising from different embryological structures such as branchial arches and somites were analysed and related to cervical lymph node involvement. RESULTS: The pattern of cervical lymph node involvement depends upon location and extension of the primary tumor in the adjacent tissues of the larynx and hypopharynx. The density of the lymphatic vessels in these areas determines the likelihood of lymph node involvement. The frequency of NO cases in carcinomas strictly located in the vocal cord (n = 31) was 100%; in the glottic-supraglottic, supraglottic, and transglottic cancer (n = 106) 85%; in larynx-hypopharynx carcinomas (n = 54) 26%; in hypopharynx carcinomas (n = 12) 17%; and in larynx-hypo-oropharynx carcinomas (n = 46) 9%. Tumors in tissues arising from branchial arches 4, 5, and 6 are glottic-supraglottic, transglottic laryngeal, and laryngeal-hypopharyngeal carcinomas. Metastases of these tumors were frequently found in the jugular lymph node chains, particularly if the developed tissue of the "primitive glottis" was invaded by the primary. Upper jugular nodes ipsilateral to a supraglottic or hypopharyngeal primary were usually involved. The frequency of metastases in the jugular lymph node chains decreased in craniocaudal direction. If the tumor invaded the posterior wall of the hypopharynx or tissues.

Adult↗
PubMed2004

Treatment of advanced cancer of the larynx and hypopharynx with chemoradiation.

AIM: To analyze the outcome of patients diagnosed with advanced cancer of the larynx and hypopharynx treated with combined chemotherapy and radiotherapy at Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia. METHODS: Analysis of prospectively gathered data concerning patients treated between 1994 and 2000 in a multidisciplinary, tertiary referral head and neck service. Outcome measures were: treatment toxicity, locoregional tumour control, and disease specific survival. RESULTS: Among 54 eligible patients, cancer involved the larynx in 31 patients and hypopharynx in 23 and, of these, 38 (70%) completed all the scheduled treatment. Chemotherapy and radiotherapy were given sequentially in 39 patients and concurrently in 15. The median age of patients was 63 years (range 35-79 years) and all but three had clinical stage III or IV disease. There were two treatment related deaths. Disease persisted in five patients and 14 others relapsed. Overall, 11 (24%) patients have had a laryngectomy; five for persistent disease, three for local recurrence and three for treatment related complications in the absence of disease. There were 15 cancer-related deaths. Cumulative disease specific survival at 2 years was 77% for the larynx cancer group and 72% for hypopharynx. The larynx was preserved in 26 of 30 patients alive at follow up. CONCLUSIONS: Patients diagnosed with advanced cancer of the larynx and hypopharynx may be considered for organ preservation treatment with chemoradiation, reserving surgery for persistent or recurrent disease. Careful patient selection is recommended because of the potential for significant treatment related toxicity.

Adult↗
PubMed2003

acp Best Practice No 169. Evidence based pathology: squamous carcinoma of the hypopharynx.

This best practice article reviews the published evidence on the pathology and patterns of spread of carcinomas of the hypopharynx, and the relevance of pathological features to prognosis. Medline (1966-2001) was searched using a combination of head and neck neoplasms and prognosis, focusing on hypopharynx and pathology. Other relevant publications were identified from the bibliographies of these papers, and from those obtained opportunistically. There is relatively little pathological literature devoted specifically to squamous carcinomas of the hypopharynx and most information comes from large series of patients with head and neck cancers at a range at sites. Lack of consistency in reporting and shifts in terminology make comparisons between series difficult. The most important features determining prognosis are size and extent of local spread of the primary carcinoma and extent of involvement of regional lymph nodes. There is evidence to support the use of the minimum dataset criteria for head and neck carcinomas at this site. Within the hypopharynx, subsite related differences in aetiology and biology may become important.

Aged↗
PubMed2006

[Treatment of superficial carcinoma in the hypopharynx].

Superficial carcinoma of the esophagus is generally treated with endoscopic mucosal resection (EMR), yielding an acceptable prognosis and quality of life (QOL). With technical advances in endoscopy, it has become to possible to find superficial carcinoma even in the hypopharynx. Several reports suggest that such superficial carcinomas are treatable only with local mucosal resection. We treated 67 superficial carcinomas (49 cases) of the hypopharynx with local mucosal resection in our hospital, mainly with EMR. From 2004, we have resected 11 lesions directly with endoscopic assist (endoscopic laryngo pharyngeal surgery; ELPS). With ELPS, it was very easy to recognize lugol-voiding lesions in the hypopharynx, and ELPS enabled us to do en bloc resection even for large lesions that could not be treated with EMR or with microscopic surgery. Eight of 49 cases had transient side effects-2 vocal cord palsies, 2 vocal cord edemas with overnight intubation, 3 overnight intubations, and 1 pharyngitis. Six patients died of other diseases, and no metastasis or recurrence of superficial carcinoma was found. Diagnosis and treatment of superficial carcinoma of the hypopharynx may thus improve patient prognosis and QOL.

Adult↗
PubMed2002

Topographical analysis of lymphatic pathways from the meso- and hypopharynx based on minute cadaveric dissections: possible application to neck dissection in pharyngeal cancer surgery.

To facilitate the development of new operative procedures for pharyngeal cancer, it is important to understand the precise location of the lymph nodes and their pathways. Minute dissection of 22 neck-halves (11 adult cadavers) was undertaken to determine the location and topographical relationships of the lymphatics of the pharynx. Four groups of lymph nodes on the drainage pathways from the meso- and hypopharynx to the internal jugular nodes were classified according to their topographical relationships to the carotid arteries: lateral pharyngeal, superior thyroid, lateral retropharyngeal and medial retropharyngeal nodes. Lymphatics from the mesopharynx passed laterally to lateral pharyngeal or jugulodigastric nodes or slightly upward to lateral retropharyngeal nodes. Lymphatic drainage from the hypopharynx was multidirectional with the pathways being classified as follows: ascending pathway to the lateral pharyngeal and lateral retropharyngeal nodes, lateral pathway to the internal jugular chain, and descending pathway connecting to the uppermost vessels ascending from the recurrent laryngeal nerve chain. In addition, a contralateral pathway was found originating from the hypopharynx extending to the contralateral internal jugular chain. These findings provide valuable information for comparison with CT and MRI studies, as well as with clinicopathological data, to clarify the precise mode of metastasis in head and neck cancers. These results are also applicable to neck dissection in meso- and hypopharyngeal cancers.

Aged↗
PubMedDate not supplied

Examination of the hypopharynx predicts ease of laryngoscopic visualization and subsequent intubation: a prospective study of 665 patients.

STUDY OBJECTIVE: To determine (a) whether the ability to visualize a patient's airway preoperatively correlates with the ability to visualize his or her larynx during laryngoscopy and (b) whether the presence of certain anatomic characteristics allows anesthetists to predict difficult laryngoscopic visualization and intubation. DESIGN: Observational. Patients were categorized into two groups: those who had one or more physical characteristics to alert an anesthetist to the possibility of difficult intubation (obesity, overbite, short neck, or decreased neck/jaw mobility) and those with none of these characteristics. SETTING: University-affiliated hospital. PATIENTS: Six hundred sixty-five patients scheduled for general anesthesia and requiring endotracheal intubation. Patients were between the ages of 18 and 88 years, with body weight ranging from 21 kg to 141 kg. INTERVENTIONS: Preoperatively, the anesthetist obtained the best view of the hypopharynx by having the patient extend the tongue and phonate. The airway was then categorized into one of three classes by the ability to see the tonsillar pillars and uvula (Class A, best view--all four tonsillar pillars and uvula seen; Class B, part of the pillars and uvula seen; Class C, worst view--pillars not seen and uvula partially or not seen). After induction, the same anesthetist graded laryngeal visibility into one of four groups depending on his ability to see the patient's epiglottis and vocal cords. MEASUREMENTS AND MAIN RESULTS: Patients with one or more clinical clues were more likely to have poor visualization of the hypopharynx and, in turn, poor laryngoscopic visualization of the glottis. Patients who had a Class A airway tended to have easy laryngoscopic visualization and were relatively easy to intubate. Conversely, patients with no clinical clues and a Class C airway had poor glottic exposure. CONCLUSIONS: Our study confirms work showing that the ability to visualize structures of the hypopharynx is a good predictor of subsequent glottic visualization during laryngoscopy and of ease of intubation.

Adolescent↗
PubMed2000

The expansion of the hypopharynx by correction of glosso-larynx.

The width of the hypopharynx and oropharynx before and after the operation correction of glosso-larynx (CGL) was compared by cranial X-ray film. After the operation, the hyoid bone was seen to have moved downward, and the cranial bone was observed to have rotated forward. As a result, the hypopharynx and the oropharynx were expanded. Expansion of the hypopharynx resulted in the decreased resistance of flow decreased and the increased in airflow.

Airway Resistance↗