Voice preservation in pyriform sinus carcinoma by hemicricolaryngopharyngectomy.

Hemicricolaryngopharyngectomy was performed for anterior pyriform sinus carcinomas with preservation of voice and swallowing. The surgical specimen includes the homolateral half of the hypopharynx, larynx, and cricoid ring. The pharynx is reconstructed with a pectoralis myocutaneous flap, a deltopectoral flap, skin or dermal graft. A semirigid mucosa-lined speech tube is created by folding in the remaining half of the larynx. This tube, which is 4 to 5 mm in diameter, serves as a phonatory structure. Speech is produced by occluding the stoma with the finger and shunting air via this dynamic pseudolarynx. Patients maintain a permanent tracheostomy. Our experience includes 14 cases with up to 4-year follow-up.