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Tumors Of Hypopharynx

  1. Hypopharynx:
    Extension: From the level of the floor of vallecula superiorly to the lower border of the cricoid inferiorly.
    1. Pyriform sinus
    2. Posterior pharyngeal wall
    3. Post cricoid area
      Most common type of tumor: Squamous cell type
  2. Clinical Symptoms:
    1. Pain : radiation to the U/L ear                                          
    2. Dysphagia
    3. Hemoptysis: Esp. with pyriform fossa tumours              
    4. Hoarseness
    5. Neck mass                                                                            
    6. Weight loss
  3. Features: Post-cricoid carcinoma:
    1. Female > Male
    2. Causes: Iron deficiency anemia
  1. Etiology for hypopharyngeal carcinoma
    1. Alcohol                                   
    2. Tobacco                  
    3. Low cholesterol
    4. Low levels of vitamin A                        
    5. Iron deficiency
  2. Treatment:
    1. Small pyriform sinus tumor with involvement of larynx: Partial pharyngectomy
    2. Pyriform sinus tumor with medial wall involvement without cord fixation: Partial pharyngectomy with Partial laryngectomy
    3. With cord fixation: Partial pharyngectomy with near total laryngectomy OR total laryngectomy
  3. Post cricoid tumor:
    1. Small tumor : Radiotherapy
    2. Large tumor : Total laryngectomy with total pharyngectomy
    3. Flaps used for repair                            
      1. Skin flap
      2. Radial forearm
      3. P. major
      4. Deltopectoral flap
    4. Visceral flaps                                         
      1. Gastric transposition
      2. Free jejunal transfer
      3. Colon transfer
    5. Feeding post-op: Percutaneous endoscopic gastrostomy (PEG) tubes

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