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ONCOLOGIC: Surgical Approaches to the Hypopharynx for Benign Disease

ONCOLOGIC: Surgical Approaches to the Hypopharynx for Benign Disease Abstract RECENT advances in knowledge of the anatomy and physiology of the hypopharynx have resulted in the use of selective surgical techniques for the resection of benign tumors of this area with minimal trauma and loss of function. The various approaches to the hypopharynx are suspension laryngoscopy, lateral pharyngotomy, anterior transhyoid pharyngotomy, and median labiomandibular glossotomy. The purpose of this paper is to describe these techniques and demonstrate their application in selected cases from our series. Anatomic Considerations We define hypopharynx as the roughly triangular space extending from the base of the tongue and valleculae to the cricopharyngeus muscle including the corresponding portions of lateral and posterior pharyngeal walls, the pyriform sinuses, and the supraglottic laryngeal structures.Suspension Laryngoscopy.—Suspension laryngoscopy, as described by Lynch1 and LaJeune,2 is particularly effective for the removal of pedunculated hypopharyngeal tumors having a limited attachment, as well as for the evaluation of lesions References 1. Lynch, R.C.: Suspension of Laryngoscopy and Its Problems , Laryngoscope 31:529, 1921.Crossref 2. LeJeune, F.E.: Technique and Uses of Suspension Laryngoscopy , Southern Med J 28:828, 1935.Crossref 3. Trotter, W.: A Method of Lateral Pharyngotomy for the Exposure of Large Growths in the Epilaryngeal Region , J Laryng 35:289-295, 1920. 4. Trotter, W.: Operations for Malignant Diseases of the Pharynx , Brit J Surg 16:485-495, 1929.Crossref 5. Orton, H.B.: Lateral Transthyroid Pharyngotomy , Arch Otolaryng 12:320-338, 1930.Crossref 6. Alonso, J.M.: Conservation of Function in Surgery of Cancer of the Larynx: Basis, Techniques and Results , Trans Amer Acad Opthal Otolaryng 56:722-730, 1952. 7. Som, M.L.: Surgical Treatment of Cancer of the Epiglottis by Lateral Pharyngotomy , Trans Amer Acad Opthal Otolaryng 63:28-47, 1958. 8. Ogura, J.H.: Supraglottic Subtotal Laryngectomy and Radical Neck Dissection for Carcinoma of the Epiglottis , Laryngoscope 68:983-1003, 1958.Crossref 9. Ogura, J.H.; Juverna, A.M.; and Watson, R.K.: Partial Laryngopharyngectomy and Neck Dissection for Pyriform Sinus Cancer , Laryngoscope 70:1399-1417, 1960. 10. New, G.B.: Treatment of Cysts of the Larynx , Arch Otolaryng 36:687-690, 1942.Crossref 11. New, G.B.: Congenital Cysts of the Tongue, the Floor of the Mouth, the Pharynx, and the Larynx , Arch Otolaryng 45:145-158, 1947.Crossref 12. Cracovaner, A.J., and Chadosh, P.L.: The Lateral Approach to the Larynx and Hypopharynx , Arch Otolaryng 71:8-15, 1960.Crossref 13. Blassingame, C.D.: The Suprahyoid Approach to Surgical Lesions at the Base of the Tongue , Ann Otol 61:483-489, 1952. 14. Portman, G.: Surgery at the Base of the Tongue by Transpharyngeal Approach , Arch Otolaryng 50:373-376, 1949.Crossref 15. Kloop, C.T., and Delaney, A.: Anterior (Median) Pharyngotomy , Arch Surg 60:1161-1170, 1950.Crossref 16. Perzik, S.L.; Rubin, H.J.; and Schorr, R.: Excision of an Obstructing Retropharyngeal Tumor in an Infant , Arch Surg 78:503-506, 1959.Crossref 17. Martin, H.; Tollefsen, H.P.; and Gerald, F.: Median Labiomandibular Glossotomy , Amer J Surg 102:753-759, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

ONCOLOGIC: Surgical Approaches to the Hypopharynx for Benign Disease

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1966.00760020224008
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Abstract

Abstract RECENT advances in knowledge of the anatomy and physiology of the hypopharynx have resulted in the use of selective surgical techniques for the resection of benign tumors of this area with minimal trauma and loss of function. The various approaches to the hypopharynx are suspension laryngoscopy, lateral pharyngotomy, anterior transhyoid pharyngotomy, and median labiomandibular glossotomy. The purpose of this paper is to describe these techniques and demonstrate their application in selected cases from our series. Anatomic Considerations We define hypopharynx as the roughly triangular space extending from the base of the tongue and valleculae to the cricopharyngeus muscle including the corresponding portions of lateral and posterior pharyngeal walls, the pyriform sinuses, and the supraglottic laryngeal structures.Suspension Laryngoscopy.—Suspension laryngoscopy, as described by Lynch1 and LaJeune,2 is particularly effective for the removal of pedunculated hypopharyngeal tumors having a limited attachment, as well as for the evaluation of lesions References 1. Lynch, R.C.: Suspension of Laryngoscopy and Its Problems , Laryngoscope 31:529, 1921.Crossref 2. LeJeune, F.E.: Technique and Uses of Suspension Laryngoscopy , Southern Med J 28:828, 1935.Crossref 3. Trotter, W.: A Method of Lateral Pharyngotomy for the Exposure of Large Growths in the Epilaryngeal Region , J Laryng 35:289-295, 1920. 4. Trotter, W.: Operations for Malignant Diseases of the Pharynx , Brit J Surg 16:485-495, 1929.Crossref 5. Orton, H.B.: Lateral Transthyroid Pharyngotomy , Arch Otolaryng 12:320-338, 1930.Crossref 6. Alonso, J.M.: Conservation of Function in Surgery of Cancer of the Larynx: Basis, Techniques and Results , Trans Amer Acad Opthal Otolaryng 56:722-730, 1952. 7. Som, M.L.: Surgical Treatment of Cancer of the Epiglottis by Lateral Pharyngotomy , Trans Amer Acad Opthal Otolaryng 63:28-47, 1958. 8. Ogura, J.H.: Supraglottic Subtotal Laryngectomy and Radical Neck Dissection for Carcinoma of the Epiglottis , Laryngoscope 68:983-1003, 1958.Crossref 9. Ogura, J.H.; Juverna, A.M.; and Watson, R.K.: Partial Laryngopharyngectomy and Neck Dissection for Pyriform Sinus Cancer , Laryngoscope 70:1399-1417, 1960. 10. New, G.B.: Treatment of Cysts of the Larynx , Arch Otolaryng 36:687-690, 1942.Crossref 11. New, G.B.: Congenital Cysts of the Tongue, the Floor of the Mouth, the Pharynx, and the Larynx , Arch Otolaryng 45:145-158, 1947.Crossref 12. Cracovaner, A.J., and Chadosh, P.L.: The Lateral Approach to the Larynx and Hypopharynx , Arch Otolaryng 71:8-15, 1960.Crossref 13. Blassingame, C.D.: The Suprahyoid Approach to Surgical Lesions at the Base of the Tongue , Ann Otol 61:483-489, 1952. 14. Portman, G.: Surgery at the Base of the Tongue by Transpharyngeal Approach , Arch Otolaryng 50:373-376, 1949.Crossref 15. Kloop, C.T., and Delaney, A.: Anterior (Median) Pharyngotomy , Arch Surg 60:1161-1170, 1950.Crossref 16. Perzik, S.L.; Rubin, H.J.; and Schorr, R.: Excision of an Obstructing Retropharyngeal Tumor in an Infant , Arch Surg 78:503-506, 1959.Crossref 17. Martin, H.; Tollefsen, H.P.; and Gerald, F.: Median Labiomandibular Glossotomy , Amer J Surg 102:753-759, 1961.Crossref

Journal

Archives of OtolaryngologyAmerican Medical Association

Published: Mar 1, 1966

References