Voice Outcome in Patients Treated With Endoscopic Laryngopharyngeal Surgery for Superficial Hypopharyngeal Cancer

Ichiro Tateya; Shuko Morita; Seiji Ishikawa; Manabu Muto; Shigeru Hirano; Yo Kishimoto; Nao Hiwatashi; Juichi Ito

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자료유형: 학술저널

저자정보: Ichiro Tateya Shuko Morita Seiji Ishikawa Manabu Muto Shigeru Hirano Yo Kishimoto Nao Hiwatashi Juichi Ito

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제9권 제1호

발행연도: 2016.1

수록면: 70 - 74 (5page)

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Objectives. Endoscopic laryngopharyngeal surgery (ELPS) is a minimally invasive transoral surgery that was developed to treat superficial larygo-pharyngeal cancer, in which a mucosal lesion is resected transorally while preserving deeper structures by subepithelial injection. The purpose of this retrospective study is to evaluate voice outcome in patients who underwent ELPS for superficial hypopharyngeal cancer. As important structures in producing voice, such as intrinsic laryngeal muscles, their fascia, and recurrent laryngeal nerve, are located in the medial side of the piriform sinus and the postcricoid region of the hypopharynx, we focused on patients with cancer lesions involving these regions. Methods. From April 2010 to March 2011, 25 consecutive patients with superficial laryngopharyngeal cancer were treated with ELPS at Kyoto University Hospital. Among the 25 patients, 11 patients with cancer lesions on the medial side of the piriform sinus or the postcricoid area were studied. Preoperative and postoperative voice functions including maximum phonation time (MPT), mean flow rate (MFR), jitter, shimmer, soft phonation index (SPI), and noise-to-harmonic ratio (NHR), were compared retrospectively. Results. Five of 11 cancer lesions had submucosal invasion and no lesion had invaded the muscular layer pathologically. T stage was classified as Tis in 5 cases, T1 in 4 cases, and T2 in 2 cases. All lesions involved the medial side of the piriform sinus and 2 also involved the postcricoid area. Vocal fold movement was normal in all cases after the surgery. Average preoperative and postoperative values for MPT, MFR, jitter, shimmer, SPI, and NHR, were 22.7 seconds and 23.4 seconds, 165 mL/sec and 150 mL/sec, 1.53% and 1.77%, 3.82% and 5.17%, 35.5 and 36.6, and 0.13% and 0.14%, respectively. There was no statistical difference between preoperative and postoperative data for all values examined. Conclusion. ELPS is useful in preserving voice function in the treatment of superficial hypopharyngeal cancer. Preserving the deeper structures including intrinsic muscles and their fascia may be important for preserving voice function as long as the lesions are superficial.

#Keywords. Phonation #Laryngeal Muscles #Narrow Band Imaging

참고문헌 (14)

참고문헌 신청

Muto M. / 2009 / Improving visualization techniques by narrow band imaging and magnification endoscopy / J Gastroenterol Hepatol 24(8):1333~1346

Manabu Muto / 2005 / Narrow Band Imaging: A New Diagnostic Approach to Visualize Angiogenesis in Superficial Neoplasia / Clinical Gastroenterology and Hepatology 3(7):S16~S20

Muto M. / 2010 / Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging : a multicenter randomized controlled trial / J Clin Oncol 28(9):1566~1572

Muto M. / 2004 / Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites / Cancer 101(6):1375~1381

Sato Y. / 2006 / Treatment of superficial carcinoma in hypopharynx / Nihon Jibiinkoka Gakkai Kaiho 109(7):581~586

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