Postoperative data of patients
All patients were followed up for 5 years. Six patients were lost by the
end of follow-up. Survival analysis was performed in accordance with the
final follow-up time. The follow-up time was 6–82 months, and the
median follow-up time was 50 months. The patients who lost follow-up
participated in the survival analysis as censored data, and the survival
time was calculated according to the last follow-up time before the loss
of follow-up. The postoperative pathology of all patients was squamous
cell carcinoma. The metastasis rate of lateral cervical lymph nodes was
74.2% (69/93). Seventy patients underwent level VI lymph node
dissection and retropharyngeal lymph node dissection. The positive rates
of region VI lymph nodes and retropharyngeal lymph nodes were 12.9%
(9/70) and 15.7% (11/70), respectively.
A total of 78 patients in this group had their larynges preserved. 11
patients underwent tongue root flap repair, 20 patients underwent
pectoralis major myocutaneous flap repair, and 5 patients underwent
subchin flap repair. Other patients performed local mucosal flap repair
of pharyngeal defects.
Pathological examination revealed that 81 patients (87%) had negative
tumor margins without lesions. Twelve cases had positive or poorly
defined margins microscopically, and in these cases, the margins of the
frozen sections were expanded until the margins were negative.
By postoperational laryngeal function evaluation methods such as
subjective sensation, voice quality,electronic laryngeal endoscopy, and
X-ray barium meal examination, 65.6% (61/93) cases showed complete
recovery of laryngeal functions (speech,respiration, and deglutition).
shown in Table 3.
Tracheal cannula removal time. Amongst the 78 patients with laryngeal
preservation, 63 patients were extubated after radiotherapy.
Unfortunately, 2 patients underwent tracheotomy and intubation again
with laryngeal edema.
During the perioperative period, four cases had internal pharyngeal
fistula, two cases experienced subcutaneous effusion, and one case
experienced bleeding at the tracheotomy, all of which were cured by
dressing change and pressure bandaging. One case of pulmonary infection
improved after switching to sensitive antibiotics. No death occurred
during the perioperative period.