Material for each volume in this series has been skillfully selected to document the most active areas of otorhinolaryngology and related specialties, such as neuro-otology and oncology. The series reproduces results from basic research and clinical studies pertaining to the pathophysiology, diagnosis, clinical symptoms, course, prognosis and therapy of a variety of ear, nose and throat disorders. The numerous papers correlating basic research findings and clinical applications are of immense value to all specialists engaged in the ongoing efforts to improve management of these disorders. Acting as a voice for its field, the series has also been instrumental in developing subspecialities into established specialities.

The series 'Advances in Oto-Rhino-Laryngology' features carefully selected materials for each volume, documenting the most active areas in otorhinolaryngology and related specialties, such as neuro-otology and oncology. It reproduces results from basic research and clinical studies related to the pathophysiology, diagnosis, clinical symptoms, course, prognosis, and therapy of various ear, nose, and throat disorders. The numerous papers that correlate basic research findings with clinical applications are immensely valuable to all specialists engaged in the ongoing efforts to improve the management of these disorders. Acting as a voice for its field, the series has also been instrumental in developing subspecialties into established specialties.

《Advances in Oto-Rhino-Laryngology》系列的每一卷材料都经过精心挑选，旨在记录耳鼻喉科及相关专业（如神经耳科学和肿瘤学）中最活跃的研究领域。该系列重现了与耳、鼻、喉疾病的病理生理、诊断、临床症状、病程、预后和治疗相关的基础研究和临床研究结果。大量将基础研究发现与临床应用相结合的论文，对所有致力于改善这些疾病管理的专家具有重要价值。作为该领域的声音，该系列在将亚专业发展为成熟专业方面也发挥了重要作用。

Advances in Oto-Rhino-Laryngology

Piero Nicolai

Patrick J. Bradley

Advances in oto-rhino-laryngology

Adv Otorhinolaryngol

Preface

前言

W. H. Johnson

Experimental Studies of Otolith Function

耳石功能实验研究

It is not uncommon for patients with hypopharyngeal cancer to present at an advanced stage of disease. Surgical treatment provides a cure for the tumour with immediate relief from obstruction to the airway and the swallowing passage. Careful planning of surgery is important to ensure good outcome of treatment and prevent complications, some of which may be fatal. The shape of the hypopharynx resembles that of a funnel, with a wide circumference above in continuity with the oropharynx, and a small circumference below where it joins with the cervical oesophagus. As a result, while small tumours require the partial removal of the hypopharynx, large tumours, especially those involving the post-cricoid region, warrant a complete, circumferential pharyngectomy. For tumours that invade the cervical esophagus, transcervical approach is still feasible, and this is facilitated by the removal of the manubrium, allowing access to the tumour and resection with clear margins. In the presence of synchronous tumours lower down in the esophagus, pharyngo-laryngo-esophagectomy is indicated. Successful reconstruction of defects after tumour extirpation allows proper wound healing and early delivery of adjuvant radiotherapy. It is also important to ensure quick recovery of the long-term swallowing function. It ranges from the use of the soft tissue flap with skin island that is sutured as a patch to the remnants of the pharyngeal mucosa, to the use of a visceral flap, such as the free jejunal flap, to repair the circumferential pharyngectomy defects. The treatment protocol is personalized according to the extent of the tumour and the characteristics of the patients.

William I. Wei

Jimmy Yu Wai Chan

Hypopharyngeal Cancer

Surgical Treatment of Advanced Staged Hypopharyngeal Cancer

晚期喉咽癌的手术治疗

Patients with hypopharyngeal cancer are difficult to treat because they typically present with advanced disease, poor general health status and severe nutritional problems. Currently, treatment options for previously untreated and newly diagnosed hypopharyngeal cancer patients include surgery of the primary tumour and lymph nodes metastasis, radiotherapy, systemic medical treatment, including traditional chemotherapy and immunotherapy. Currently, a multimodal treatment approach is preferred using surgery, radiotherapy and systemic therapy with curative intent and best supportive care in patients considered unfit for curative treatment or patients presenting with distant metastatic spread. More detailed topics regarding the choice of treatment include biological and immunological host factors and their use for defining individualised cancer care, integration of novel therapies, integration of patient autonomy into clinical reasoning and dealing with patients' trade-offs between oncological outcome and individual quality of life, local availability of diagnostic therapeutic procedures and volume-outcome relationships for head and neck cancer surgery, radiotherapy and specialised supportive care. They also include considerations regarding potential delay between diagnosis and treatment, and between different treatment modalities within the frame of multimodal therapy. To date only one randomised trial comparing surgical versus non-surgical approaches has been published. Most randomised trials dealing with hypopharyngeal cancer compare different chemo- and radiotherapy regimen, but do not compare with a surgical approach. On the other hand, most studies on the results of surgery are best considered to be of low-quality case series. At the same time, many of the chemotherapy and radiation oncology studies in head and neck cancer include patients with different primary sites, where hypopharyngeal cancer patients when included usually account for a minority of the study population. Therefore, choosing the best treatment for an individual patient with hypopharyngeal cancer relies on personal experience and local expertise of the multidisciplinary team involved in the therapeutic process.

ISSN	0065-3071, 1662-2847
h-index	43

Publication Information	Publisher: S. Karger AG，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2009，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%

Advances in Oto-Rhino-Laryngology

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Preface

Experimental Studies of Otolith Function

Surgical Treatment of Advanced Staged Hypopharyngeal Cancer

Treatment Options for Hypopharyngeal Cancer

Preface

Surgical Treatment of Advanced Staged Hypopharyngeal Cancer

Treatment Options for Hypopharyngeal Cancer

Experimental Studies of Otolith Function