경설골 인두절개술의 경험 례

Carcinoma of the hypopharynx without involvement of the larynx presents a management problem in that it appears that best survival is achieved by performing a total hypopharyngectomy associated with preoperative adjuvant chemotherapy (Spaulding et al., 1983). But there are many difficult problems about reconstruction of the hypopharynx after total hypopharyngectomy.

In the methods of hypopharynx approach, first, lesions approximately less than 2cm in diameter without palpable cervical lymphadenopathy are usually resectable via an anterior transhyoid pharyngotomy or a median labio-mandibular glossotomy and second, with larger lesions and with all lesions associated with palpable cervical lymphadenopathy, a transhyoid pharyngotomy and lateral pharyngotomy approach combined with neck dissection, or the mandibular swing, is preferred.

Recently, we could have better operation field without total hypopharyngectomy and obtained quite a satisfactory results, when radical neck dissection with transhyoid pharyngotomy as applied to hypopharynx cancer with palpable cervical lymph-adenopathy.

In addition, posterior pharyngeal wall laceration due to neck trauma could be repaired easily via transhyoid pharyngotomy with good results. So, we reported this effective approach with review of literatures.