Primary surgery and postoperative Radiotherapy (RT) remains an important tool in the treatment of CPWH, but postoperative morbidity and reconstructive challenges of the surgical defect, which impacts swallowing, speech and respiration, has an important influence on choosing the therapeutic approach. 3 Because of its rarity, there are few studies published in the literature specifically concerning Carcinoma of the Posterior Wall of the Hypopharynx (CPWH). Squamous cell carcinoma of the hypopharynx represents only 3%–5% of all squamous cell carcinomas of the head and neck region 1,2 and posterior pharyngeal wall, is the most rare subsite for hypopharyngeal carcinomas. Primary surgery is still a very effective treatment modality for the carcinoma of the posterior wall of the hypopharynx and does not permanently compromise the swallowing and laryngeal functions if pharyngeal reconstruction is performed with a free flap. One patient died due to regional recurrence in the retropharyngeal lymph nodes and 1 patient died due to systemic metastasis. The mean followup duration was 38.3 months (range, 10–71 months) and 8 patients survived. Decannulation was achieved in all patients and the median time for decannulation was 90 (range, 21–300 days). All patients achieved oral intake in a median time of 74 days (range, 15–180). The mean duration of hospitalization was 15.6 days (range, 10–21 days). Four patients received adjuvant radiotherapy only, and 4 patients with N2b and N2c neck diseases received adjuvant chemoradiotherapy. The pharyngeal defects were reconstructed successfully with radial forearm free flaps. The preferred approach to access the hypopharynx was a lateral pharyngotomy in 5 patients and lateral pharyngotomy combined with infrahyoid pharyngotomy in 5 patients with superior extension to oropharynx. Nine patients had T3 lesions and one patient had a T2 lesion. The associated postoperative morbidity was investigated and functional results were analyzed. The study included 10 patients who underwent surgery for a carcinoma of the posterior wall of the hypopharynx over a 6 year period. To report our functional results in patients with the carcinoma of the posterior wall of the hypopharynx after surgical treatment by resection via a lateral or infrahyoid pharyngotomy approach, with the preservation of the larynx and reconstruction with a radial forearm free flap. Because of its rarity, there are few studies published in the literature specifically concerning posterior pharyngeal wall carcinoma. Posterior pharyngeal wall is the most rare subsite for hypopharyngeal carcinomas.
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