I. Treatment steps: (a) History questioning and physical examination. Xie Guang, Department of Otolaryngology, Qilu Hospital, Shandong University, present medical history records: whether there is hoarseness, whether there is difficulty in swallowing, whether there is sore throat (especially hypopharyngeal cancer), whether there is coughing with blood in sputum, whether there is wasting, etc. Past history, personal history records: smoking, alcohol consumption, special hobbies or characteristics related to the disease, family history. Specialized examination focuses on observation and recording, 1. Hypopharynx and larynx: the extent of mass infiltration and its size, epiglottis morphology, aryepiglottis fold morphology, phial movement (good activity, restricted activity, fixed), ventricular zone morphology, laryngeal chamber situation, vocal fold movement (good activity, restricted activity, fixed), subglottic situation, whether the pear-shaped fossa is symmetrical, whether it is full, whether there is fluid accumulation; supraglottic type also needs to describe the epiglottic valley, tongue root 2. Neck examination: examine whether there are enlarged lymph nodes on both sides of the neck, describe their location, number, size, texture, mobility and whether they are adherent to the surrounding tissues, etc.; whether the laryngeal body is bulging and its movement (whether there is a sense of friction). The presence or absence of trismus sign in the chest. The presence or absence of hepatosplenomegaly, the presence or absence of dry or wet mono oyster bow bilirubrium (chest X-ray, ultrasound to understand the presence or absence of distant metastases such as lung, liver and spleen, whole body bone scan) (b) Clear diagnosis and determination of the extent of mass infiltration. Freehand or electronic laryngoscopic biopsy to clarify the nature of the mass by pathological examination. CT or MRI of the hypopharynx and larynx to clarify the extent of the lesion, and barium swallow of the esophagus to understand whether the esophagus is invaded (electronic gastroscopy if necessary). Ultrasound examination of the neck (DSA if necessary) is also required if invasion of large blood vessels in the neck is suspected. (iii) Determine the treatment plan based on the diagnosis. The treatment plan should be determined according to the nature and extent of the mass, whether there is distant metastasis, the efficacy of various treatment techniques, and the wishes of the patient and family members. Radiotherapy can be chosen for hypofractionated squamous carcinoma. T1 and T2 lesions can be treated with radiotherapy alone or surgery in primary cases, while T3 and T4 lesions need to be treated with comprehensive treatment, i.e. radiotherapy before or after surgery (some patients can be treated with induction chemotherapy). Recurrent cases can be treated with surgery or radiotherapy depending on the specific situation. Patients with lymph node metastasis in the neck can choose neck dissection. Diagnostic criteria: (refer to 2002 UICC criteria) III. Treatment plan during surgery: 1. Pre-surgical examination: general anesthesia routine, thyroid function, tumor five, chest X-ray, electrocardiogram, abdominal ultrasound, barium swallow photo of esophagus, CT or MRI of hypopharynx or larynx in our department. additional examination: electronic gastroscopy, neck ultrasound, DSA angiography, whole body bone scan, thyroid nuclear scan. Pulmonary function tests are also required in older patients. Bedside tracheotomy kits are required for those with II degree respiratory distress. The patient should be immediately tracheotomized for degree III and IV. 2. choice of anesthesia: endotracheal anesthesia after tracheotomy. 3. preoperative and intraoperative medication and preparation: preoperative Dopey’s solution with gargle and oral antibiotics for 3-5 days, intravenous antibiotics 12 hours before surgery, intraoperative medication (usually cephalosporin III antibiotics) is also required if the operation lasts more than 4 hours and bleeding exceeds 1000 ml. Sleeping pills are given the night before surgery. Gastrointestinal preparation (enema) is required before surgery if gastric substitution of esophagus or colonic substitution of esophagus is performed.4. Surgical orders: atropine and luminal are injected intramuscularly 30 minutes before surgery, skin preparation, fasting 8 hours before surgery, blood preparation 400-800ml (depending on the size of the operation, whether to prepare and dosage), bringing CT film or MRI film into the operating room, substituting antibiotics into the operating room, substituting tracheal cannula into the operating room (depending on the type of surgery). 5.Postoperative treatment: daily dressing change for the first 3 days after surgery (if the dressing is soaked by oozing, change it at any time), wound pressure dressing is needed for 7 days. Generally the first day to remove the subcutaneous drainage strip and can be nasal fluid. The drainage tube is removed on day 2 (when the daily drainage is less than 20 ml). Blood count and biochemistry 11 are rechecked on day 3. The stitches were removed on the 7th postoperative day. If the laryngectomy is not extensive (e.g. one side of the vocal cord), the swallowing action can be practiced on the 8th and 9th day, and the soft food can be tried through the mouth on the 10th day, and the gastric tube can be removed if it goes well. For partial laryngectomy with a wide range (e.g., 3/4 laryngectomy), try to eat and perform articulation training on the 12th-14th postoperative day, and discharge with the tube on, and return to the hospital after 3 months for electronic laryngoscopy to decide whether to block and remove the tube. Patients can be asked to get out of bed as much as possible on the 1st and 2nd postoperative day. Gastrointestinal decompression is needed for 2-3 days for gastric substitution or colonic substitution, and nasal fluid can be given after anal venting. 6. Postoperative medical advice: post-tracheotomy care, oral care, 24-hour in and out volume, gastric medication (such as ranitidine, loxacillin, etc.), phlegmolytic medication (Mucosolvan, etc.), three-liter bag of nutrient solution, intravenous antibiotics (cefadroxil and metronidazole can be used for 7 days), hemostatic medication (used for 3 days). Dobei’s liquid gargle and nebulized inhalation (Formula II) were started on the 1st postoperative day. IV. Post-discharge follow-up plan is reviewed every 3 months for the first year, every 6 months for the next 2-3 years, and then once a year for life. Review items: electronic laryngoscopy of the hypopharynx and larynx, palpation of the neck. CT or MRI of the neck, routine blood, biochemistry, chest X-ray, barium swallow of the esophagus, and ultrasound of the abdomen, etc., if necessary. V. Efficacy evaluation: tumor-free survival rate, survival rate with tumor, quality of survival, etc. This article is authorized by Dr. Xie Guang.