Laryngopharyngeal cancer, also known as hypopharyngeal cancer. The cause of laryngopharyngeal cancer is still unknown, but some epidemiological studies suggest that excessive smoking and alcohol may be related to the formation of laryngopharyngeal cancer. Other factors such as viral infection and chronic irritation of the pharynx by gastroesophageal reflux may also be responsible for the occurrence of laryngopharyngeal cancer. Laryngopharyngeal cancer accounts for about 0.8% to 1.5% of malignant tumors of head and neck. Although the proportion is not high, it is not easy to be detected in early stage because of the deep and hidden location of hypopharyngeal cancer, the early symptoms are not obvious or light, and indirect laryngoscopy is difficult, thus once there are symptoms, more than 60% of patients are already in advanced stage, which is difficult to treat and the prognosis is poor. Only early detection and early treatment can achieve better treatment effect. Clinical manifestations of laryngopharyngeal cancer Early stage of laryngopharyngeal cancer only includes slight throat discomfort, foreign body sensation in the throat and slight sore throat. Because the laryngopharyngeal area is deep and hidden, laryngopharyngeal cancer is not easily detected at an early stage and is often misdiagnosed as chronic laryngitis. If the tumor is not detected in time or the examination is not timely, after 3-5 months, symptoms such as throat pain, phlegm and blood, dysphagia, dysphagia, cough and choking, dyspnea and hoarseness may appear, and some patients may have a lump in the neck (this is actually cervical lymph node metastasis), by which time most patients have reached advanced stage. Laryngopharyngeal cancer examination If you have the above symptoms, you must go to hospital for serious specialist examination. If indirect laryngoscopy is unsatisfactory, you must use fiber laryngoscope and laryngeal speculum examination, and if you suspect tumor in the tip of pear-shaped fossa or esophageal entrance, you should perform barium esophageal penetration examination or CT scan to detect tumor as early as possible. After the tumor is detected by outpatient or laryngoscopy, the tumor should also be excised for pathological examination. Treatment of laryngopharyngeal cancer In early stage laryngopharyngeal cancer, if there is no laryngeal invasion or one side of the larynx is normal, when removing laryngopharyngeal cancer, the uninvolved part of the larynx can be preserved and all or part of the larynx can be restored through repair. Advanced laryngopharyngeal cancer is a comprehensive treatment mainly based on surgery, and surgery and radiotherapy are the most effective treatment methods. The combination of surgery and radiotherapy can effectively improve the cure rate and laryngeal function preservation rate of laryngopharyngeal cancer. In laryngopharyngeal cancer, if the tumor is confined to the hypopharynx and does not invade the laryngeal body, the whole larynx or part of the larynx can be preserved, but this requires doctors with very rich clinical experience and surgical skills. If the surgeon does not have the surgical skills to preserve the larynx, or the tumor has invaded most of the laryngeal body, or the tumor has invaded the tip of the pyriform fossa and the entrance of the esophagus, the whole larynx should be removed along with the hypopharyngeal cancer. The surgery should remove the defect of mucosa of laryngopharynx and esophageal entrance caused by laryngopharyngeal tumor after surgery. If the defect of mucosa is not much, the laryngopharyngeal incision can be closed by pulling together the anastomosis. If the laryngopharyngeal mucosal defect is too much, it cannot be repaired by pulling together the anastomosis and other materials must be used. The repair of laryngopharyngeal and esophageal entrance mucosal defects is more difficult and is the most difficult operation in laryngopharyngeal cancer surgery. If the mucosal defect is small, the defect can be repaired by pectoralis major flap or forearm flap, and if the tubular defect is small, it is better to repair it by forearm or lateral femoral flap or jejunum, and one cannot just try to operate well and use gastropharyngeal anastomosis. Gastropharyngeal anastomosis should be used only when the defect is below the thoracic inlet. The most appropriate repair method to repair the laryngopharyngeal defect should be selected clinically according to the patient’s specific situation and the repair methods available to the surgeon. The commonly used repair methods are as follows. 1.Sternocleidomastoid flap Sternocleidomastoid flap repair and reconstruction of the hypopharyngeal cervical esophagus is easy to operate, less traumatic, and has a high success rate, so it is one of the commonly used methods. 2.Free forearm flap, anterolateral femoral flap and jejunum Free forearm flap, anterolateral femoral flap and jejunum are the best methods to repair hypopharyngeal and cervical esophageal defects, no swelling and good swallowing function after surgery, but free forearm flap, anterolateral femoral flap and jejunum should be anastomosed when repairing hypopharyngeal and cervical esophageal defects, which has high technical requirements for the surgeon; the operation time is long and has high requirements for the surgeon’s physical ability. 3.Gastropharyngeal anastomosis, also known as gastric substitution of esophagus, is performed after removing laryngopharyngeal tumor and total larynx, and also removing esophagus. After the esophagus is stripped, the stomach is pulled through the bed of the esophagus to the neck and anastomosed with the pharynx. Its main disadvantages are: the surgery is very traumatic and has many complications. Complications such as bleeding (hemothorax), gastric necrolysis, pleural effusion, and pneumonia can occur; the patient’s digestive function is greatly affected, and symptoms such as reflux and frequent vomiting often occur after eating due to poor gastric peristaltic movement. Chest and stomach expansion and compression after eating causes chest tightness. The thoracic stomach has certain stimulation to the heart and lungs, and gastropharyngeal anastomosis cannot be used in old and weak people with poor cardiopulmonary function. If the laryngopharyngeal defect can be repaired with pectoralis major flap, free forearm flap, anterolateral femoral flap and jejunum, gastropharyngeal anastomosis should not be used as much as possible.