International Journal of Phonosurgery & Laryngology

Register      Login

VOLUME 2 , ISSUE 1 ( January-June, 2012 ) > List of Articles

CASE REPORT

Untreated Cleft Palate a Unique Surgical Contraindication in Carcinoma of the Pyriform Fossa

Sudhir M Naik

Citation Information : Naik SM. Untreated Cleft Palate a Unique Surgical Contraindication in Carcinoma of the Pyriform Fossa. Int J Phonosurg Laryngol 2012; 2 (1):33-36.

DOI: 10.5005/jp-journals-10023-1032

Published Online: 01-06-2012

Copyright Statement:  Copyright © 2012; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background/objectives

Swallowing problems following total laryngectomy are significantly lesser compared to other partial laryngectomies as a permanent seperation between the trachea and esophagus is seen in the earlier. Sometimes, the patient complains of difficulty in propelling bolus through the oral cavity and pharynx as a result of the loss of hyoid bone, which is the anchor for the tongue. The increased pressure in the narrowed pharyngoesophageal segment following laryngectomy requires the tongue to move with greater force.

Setting

Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru.

Case report

A 52-year-old man with history of difficulty and pain while swallowing and diagnosed as squamous cell carcinoma of the right pyriform fossa extending to the pharyngoepiglottic fold. Incidently, the patient had an old untreated cleft palate. Assessment of the pharyngeal wall involvement on direct laryngoscopy proved that pectoralis major myocutaneous flap patch was needed to reconstruct the pharyngeal lumen. Cleft palate proved a contraindication for surgery as the oral swallowing phase would be affected.

Conclusion

Current management protocols of hypopharyngeal cancers include multifactorial assessment of anatomical and functional outcomes and rehabilitation. Even though no literature is found stating cleft palate as the contraindication for total laryngectomy, chemoradiation was preferred citing swallowing problems.

How to cite this article

Naik SM. Untreated Cleft Palate a Unique Surgical Contraindication in Carcinoma of the Pyriform Fossa. Int J Phonosurg Laryngol 2012;2(1):33-36.


PDF Share
  1. Epidemiology of head and neck cancer in the United States. Otolaryngol Head Neck Surg 2006;135: 451-57.
  2. Dietary risk factors for hypopharyngeal cancer in India. Cancer Causes Control 2008;19:1329-37.
  3. Smokeless tobacco and increased risk of hypopharyngeal and laryngeal cancers: A multicentric case-control study from India. Int J Cancer 2007;121:1793-98.
  4. Squamous cell carcinoma of the hypopharynx: Single-institution outcome analysis of a large cohort of patients treated with primary nonsurgical approaches. Acta Oncol 2009;48:541-48.
  5. Hypopharyngeal cancer patient care evaluation. Laryngoscope 1997;107:1005-17.
  6. Postoperative radiotherapy in hypopharyngeal cancer: Single-institution outcome analysis. Int J Head Neck Surg 2010 Jan-April;1(1):1-8.
  7. Squamous cell carcinoma of the pyriform sinus. Laryngoscope 1982;92:357-64.
  8. Head and neck squamous cell carcinoma: The role of postoperative adjuvant radiotherapy. J Surg Oncol 2005;91: 48-55.
  9. Combined surgery and radiation therapy for squamous cell carcinoma of the hypopharynx. Otolaryngol Head Neck Surg 1997;116:637-41.
  10. Surgery and postoperative radiotherapy for squamous cell carcinoma of the larynx and pharynx. Am J Clin Oncol 2006;29:613-21.
  11. Evaluation and management of oropharyngeal dysphagia in head and neck cancer. Cancer Control 2002 Sept/Oct;9(5).
  12. Management of vallecular pseudodiverticulum. Ann Otol Rhinol Laryngol 1980;89:201-03.
  13. Concurrent radiochemotherapy in advanced hypopharyngeal cancer. Radiation Oncology 2010;5:39.
  14. Radical radiotherapy in head and neck squamous cell carcinoma: An analysis of prognostic and therapeutic factors. Clin Oncol 2006;18:383-89.
  15. Carcinoma of the hypopharynx. Surg Oncol Clin N Am 2004;13:81-98.
  16. A performance status scale for head and neck cancer patients. Cancer 1990;66: 654-59.
  17. Swallowing and quality of life after total laryngectomy and pharyngolaryngectomy: Braz J Otorhinolaryngol 2009 July/Aug;75(4).
  18. Treatment of hypopharyngeal carcinoma: A 10-year review of 1,362 cases. Laryngoscope 1987;97:901-04.
  19. Squamous cell carcinoma of the hypopharynx-analysis of treatment results. Head Neck 1993;16:405-12.
  20. Effect of a maxillary glossectomy prosthesis on articulation and swallowing. J Prosth Dent 1987;57(96):715-20.
  21. Pharyngocutaneous fistula following total laryngectomy. Acta Otorhinolaryngol Ital 2007;27(1):2-5.
  22. Deglutition Problems in head and neck cancer patients. The Int J Otorhinolaryngol 2003;2(1).
  23. Factors in successful deglutition following supraglottic laryngeal surgery. Ann Otol Rhinol Laryngol 1982;91(6 Pt.1):579-83.
  24. Swallowing disorders in three types of head and neck surgical patients. Cancer 1979;44(3):1095-1105.
  25. Examination of swallowing after total laryngectomy using manofluorography. Head Neck 1986;94:3-12.
  26. The pharynx after laryngectomy. Laryngoscope 1963;73:18-33.
  27. Primary closure of pharyngeal remnant after total laryngectomy and partial pharyngectomy: How much residual mucosa is sufficient? Laryngoscope 1996;16:490-94.
  28. Laser treatment of symptomatic anterior pharyngeal pouches after laryngectomy. Head Neck 1999;21(4):310-14.
  29. Changes of esophageal motility after total laryngectomy. Otolaryngol Head Neck Surg 2003;128(5):691-99.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.