Partial laryngectomy in supraglottic pharyngeal tumors.
Por:
Gallegos-Hernández J.F.
Publicada:
1 ene 2010
Categoría:
Surgery
Resumen:
The upper third of the larynx shares a wall with the pharynx, the laryngopharyngeal wall. This anatomic structure is common to both organs and is often the source of epidermoid carcinomas. These carcinomas are more frequent in subjects who ingest large amounts of alcohol. The purpose of this study is to describe the indications, contraindications, technical errors and surgical technique of the supracricoid hemilaryngopharyngectomy and horizontal supraglottic laryngectomy. These tumors are usually bulky, respect laryngeal function and are limited to this anatomic structure. Laryngeal mobility is respected through advanced stages of the disease. Because tumors originating in this region are highly lymphophilic (presenting occult nodal metastasis in up to 45%), both techniques should be accompanied by cervical lymph node dissection, generally bilateral, and including at least levels II to IV. The presence of lymph node metastases is not an absolute contraindication for these procedures. We describe two surgical techniques designed to obtain adequate cancer control, preserving the natural functions of swallowing, speech and ventilation in patients with tumors arising in the supraglottic region and the region between the larynx and hypopharynx.
Filiaciones:
Gallegos-Hernández J.F.:
Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D. F., Mexico
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