Partial laryngopharyngectomy for piriform sinus carcinoma. Technique and preliminary results.

This paper presents a technique for partial laryngopharyngectomy followed by a one-stage reconstruction and its preliminary results. This surgery is indicated for carefully selected cases in which the lesion is confined to the ipsilateral piriform sinus, aryepiglottic fold, arytenoid eminence and paraglottic space at the level of the false fold. The hyoid bone, thyroid ala, arytenoid cartilage, epiglottis, aryepiglottic fold, arytenoid eminence and false fold are removed on the affected side. Reconstruction is performed with the use of a pectoralis major myocutaneous (PMMC) flap. The surgery was performed on four cases: two were successful; one suffered from persistent postsurgical aspiration because the reconstructed hypopharynx was too wide; and one developed necrosis of PMMC flap and a secondary reconstruction procedure was performed.