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Novel laryngoscopic strategies to improve evaluation of the site and extent of primary hypopharyngeal tumours

Published online by Cambridge University Press:  13 August 2013

X-G Ni ,
R-R Cheng ,
S-Q Lai ,
L Zhang ,
S He ,
Y-M Zhang  and
G-Q Wang
X-G Ni
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
R-R Cheng
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
S-Q Lai
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
L Zhang
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
S He
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
Y-M Zhang
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
G-Q Wang*
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
*
Address for correspondence: Dr Gui-Qi Wang, Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, 17 Panjiayuan, Chaoyang District, PO Box 2258, Beijing 100021, PR China Fax: +86 10 87711782 E-mail: [email protected]
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Abstract

Objective:

To investigate different strategies for displaying the hypopharynx and oesophageal entrance during laryngoscopy for hypopharyngeal cancer.

Patients and methods:

A total of 113 patients with hypopharyngeal cancer underwent laryngoscopy prior to surgery. The hypopharynx was displayed by: (1) pulling the anterior cervical skin; (2) having the patient perform the Valsalva balloon-blowing manoeuvre; and (3) injecting oxygen through the biopsy channel to expose the oesophageal entrance. The effect of these methods on visualisation of primary tumour size and extent was assessed.

Results:

During pronunciation of the letter ‘e', the hypopharynx was displayed in only 33 patients (29.2 per cent); with anterior cervical skin traction plus the balloon-blowing manoeuvre, the hypopharynx was displayed in 106 patients (93.8 per cent; p < 0.001). The combined strategy was superior especially when judging the extent of posterior pharyngeal wall and postcricoid invasion. Oesophageal entrance involvement was visible in 33 patients upon injecting oxygen through the laryngoscopic biopsy channel, and in 25 patients during radiological examination; laryngoscopy was superior to radiological examination in determining the extent of oesophageal entrance invasion (p = 0.003).

Conclusion:

Adequate laryngoscopic display of the hypopharynx could increase the accuracy of pre-treatment hypopharyngeal cancer staging.

Keywords

Hypopharyngeal NeoplasmsLaryngoscopyNeoplasm Staging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 882 - 889
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Hall, SF, Groome, PA, Irish, J, O'Sullivan, B. The natural history of patients with squamous cell carcinoma of the hypopharynx. Laryngoscope 2008;118:1362–71CrossRefGoogle ScholarPubMed
2Gourin, CG, Terris, DJ. Carcinoma of the hypopharynx. Surg Oncol Clin N Am 2004;13:81–98CrossRefGoogle ScholarPubMed
3Lin, DT, Cohen, SM, Coppit, GL, Burkey, BB. Squamous cell carcinoma of the oropharynx and hypopharynx. Otolaryngol Clin North Am 2005;38:59–74CrossRefGoogle ScholarPubMed
4Corvò, R. Evidence-based radiation oncology in head and neck squamous cell carcinoma. Radiother Oncol 2007;85:156–70CrossRefGoogle ScholarPubMed
5Zbären, P, Becker, M, Läng, H. Pretherapeutic staging of hypopharyngeal carcinoma. Clinical findings, computed tomography, and magnetic resonance imaging compared with histopathologic evaluation. Arch Otolaryngol Head Neck Surg 1997;123:908–13CrossRefGoogle ScholarPubMed
6Sewnaik, A, Hoorweg, JJ, Knegt, PP, Wieringa, MH, van der Beek, JM, Kerrebijn, JD. Treatment of hypopharyngeal carcinoma: analysis of nationwide study in the Netherlands over a 10-year period. Clin Otolaryngol 2005;30:52–7CrossRefGoogle ScholarPubMed
7Wycliffe, ND, Grover, RS, Kim, PD, Simental, A Jr.Hypopharyngeal cancer. Top Magn Reson Imaging 2007;18:243–58CrossRefGoogle ScholarPubMed
8Mehta, PS, Harrison, LB. Function and organ preservation in adult cancers of the head and neck. Expert Rev Anticancer Ther 2007;7:361–71CrossRefGoogle ScholarPubMed
9Hall, SF, Groome, PA, Irish, J, O'Sullivan, B. Radiotherapy or surgery for head and neck squamous cell cancer: establishing the baseline for hypopharyngeal carcinoma? Cancer 2009;115:5711–22CrossRefGoogle ScholarPubMed
10Keberle, M, Kenn, W, Hahn, D. Current concepts in imaging of laryngeal and hypopharyngeal cancer. Eur Radiol 2002;12:1672–83CrossRefGoogle ScholarPubMed
11Watanabe, A, Hosokawa, M, Taniguchi, M, Tsujie, H, Sasaki, S. Impact of endoscopic screening on early detection of hypopharyngeal cancer. Head Neck 2006;28:350–4CrossRefGoogle ScholarPubMed
12Joo, YH, Cho, KJ, Park, JO, Nam, IC, Kim, MS. Role of larynx-preserving partial hypopharyngectomy with and without postoperative radiotherapy for squamous cell carcinoma of the hypopharynx. Oral Oncol 2012;48:168–72CrossRefGoogle ScholarPubMed
13Henrot, P, Blum, A, Toussaint, B, Troufleau, P, Stines, J, Roland, J. Dynamic maneuvers in local staging of head and neck malignancies with current imaging techniques: principles and clinical applications. Radiographics 2003;23:1201–13CrossRefGoogle ScholarPubMed
14Hillel, AD, Schwartz, AN. Trumpet maneuver for visual and CT examination of the pyriform sinus and retrocricoid area. Head Neck 1989;11:231–6CrossRefGoogle ScholarPubMed
15Popescu, CR, Bertesteanu, SV, Mirea, D, Grigore, R, lonescu, D, Popescu, B. The epidemiology of hypopharynx and cervical esophagus cancer. J Med Life 2010;3:396–401Google ScholarPubMed