ABSTRACT
Advanced cancer of the laryngopharynx and cervical esophagus is difficult to treat because of the malnutrition produced by pain and obstruction and the problems related to reconstruction. This paper presents the initial results of a regimen used in 14 patients in which there is rapid reversal of nutritional deficiencies, radical resection, and reconstruction using the gastric pull-up technique and administration of postoperative radiotherapy. Excellent overall palliation and decreased hospitalization have been achieved using this regimen without diminishing chances for cure.
Subject(s)
Esophageal Neoplasms/therapy , Laryngeal Neoplasms/therapy , Pharyngeal Neoplasms/therapy , Adolescent , Adult , Aged , Enteral Nutrition , Esophageal Neoplasms/radiotherapy , Esophageal Neoplasms/surgery , Female , Humans , Laryngeal Neoplasms/radiotherapy , Laryngeal Neoplasms/surgery , Male , Middle Aged , Neck Dissection , Palliative Care , Parenteral Nutrition, Total , Pharyngeal Neoplasms/radiotherapy , Pharyngeal Neoplasms/surgery , Stomach/surgeryABSTRACT
Carcinoma of the base of the tongue has been treated with various combinations of radiotherapy and surgery. Resection of this area poses a major problem in reconstruction because of the need for establishing normal physiologic characteristics. This article emphasizes the benefits of a lateral pharyngotomy and mandibulotomy for resection of large portions of the tongue base. We describe a tongue flap with a neurovascular pedicle that is set back into the tongue-base deficit. This one-stage procedure is relatively easy to perform and provides good physiologic results.
