Head and Neck

Histoanatomical characteristics to increase the success in transoral surgery for hypopharyngeal cancer

Corresponding Author

Shun-ichi Chitose MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

Send correspondence to Shun-ichi Chitose, MD, Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. E-mail: [email protected]Search for more papers by this author

Kiminori Sato MD,

Kiminori Sato MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Mioko Fukahori MD,

Mioko Fukahori MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Shintaro Sueyoshi MD,

Shintaro Sueyoshi MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Takashi Kurita MD,

Takashi Kurita MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Takeharu Ono MD,

Takeharu Ono MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Buichiro Shin MD,

Buichiro Shin MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Ryota Mihashi MD,

Ryota Mihashi MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Hirohito Umeno MD,

Hirohito Umeno MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Shun-ichi Chitose MD,

Corresponding Author

Shun-ichi Chitose MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

Kiminori Sato MD,

Kiminori Sato MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Mioko Fukahori MD,

Mioko Fukahori MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Shintaro Sueyoshi MD,

Shintaro Sueyoshi MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Takashi Kurita MD,

Takashi Kurita MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Takeharu Ono MD,

Takeharu Ono MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Buichiro Shin MD,

Buichiro Shin MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Ryota Mihashi MD,

Ryota Mihashi MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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Hirohito Umeno MD,

Hirohito Umeno MD

Department of Otolaryngology–Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan

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First published: 24 March 2016

https://doi.org/10.1002/lary.25965

Citations: 11

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

Transoral laser microsurgery (TLM) for hypopharyngeal cancer results in a lower incidence of complications than conventional open surgery. However, additional knowledge regarding the histoanatomical characteristics of the hypopharynx is necessary to prevent severe complications during TLM. The purpose of this study is to investigate the histoanatomical characteristics of the hypopharynx for TLM.

Study Design

Histoanatomical study.

Methods

Whole organ serial sections of three hypopharynges and larynges from autopsy cases were subjected to hematoxylin & eosin and Elastica van Gieson staining. Surgical histoanatomy of the hypopharynx was observed with each section, and the histoanatomical characteristics directly related to TLM performance were examined microscopically.

Results

The histological structures of muscle layers showed obvious differences between each hypopharyngeal subsite. The posterolateral wall had two kinds of pharyngeal elevator muscles. These fasciae were connected to the perichondrium of the thyroid cartilage. The anterolateral wall between the superior horn and the lamina of the thyroid cartilage had no muscle layer. The superior laryngeal artery and the internal branch of the superior laryngeal nerve run into the larynx and hypopharynx at that site. The inner perichondrium of the thyroid cartilage was present beneath the mucosa. The dihedral angle of the anterior piriform fossa had a deep propria mucosa and paraglottic space. The postcricoid wall consisted of a multilayered structure, including cricoid cartilage covered with laryngeal muscles and mucosa.

Conclusion

A precise understanding of the histoanatomical characteristics of the hypopharynx increases the success of TLM, decreases complication rates, and improves laryngeal preservation.

Level of Evidence

N/A. Laryngoscope, 126:1783–1789, 2016

BIBLIOGRAPHY

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Citing Literature

Volume126, Issue8

August 2016

Pages 1783-1789

Histoanatomical characteristics to increase the success in transoral surgery for hypopharyngeal cancer

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Histoanatomical characteristics to increase the success in transoral surgery for hypopharyngeal cancer

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

Information