Figure2 Pictures of surgical procedures
A Exposure of lateral edge of thyroid cartilage plate.B After the moderate outwards traction and lysis of the
surrounding tissue, the parglottic space was exposed. C Enter
the pharyngeal cavity from the paraglottic space and remove the tumour
under direct vision. D Remove the tumour along the safe
boundary of the tumour. E the mucosa of the posterior wall of
the hypopharynx is sutured up and down to widen the pharyngeal cavity.F Suture the pharyngeal mucosa and close the pharyngeal cavity
2. Repair
For stage T1 and T2 lesions, the pharyngeal cavity can mostly be closed
with local mucosal pulling sutures after tumour resection. For stage T3
and T4 lesions, such as the tumour of the lateral wall of the piriform
sinus invading the posterior wall of the hypopharynx or the tumour
invading the entrance of the oesophagus, the defect of the lateral wall
of the pharynx is so large that it is difficult to pull and suture
directly after tumour resection. The most common method we use to repair
the pharyngeal cavity is pedicled pectoralis major myocutaneous flap
(Such as Video2). In addition, after the pharyngeal cavity was closed,
the ipsilateral uninvolved thyroid lobe was lifted and fixed on the
lateral side of the pharyngeal suture to strengthen the pharyngeal wall
and reduce the incidence of pharyngeal fistula.