Medically, the pharynx is divided into the pharynx and larynx according to the anatomical location of the body. The pharynx is further divided into three parts: nasopharynx (from the posterior end of the nasal cavity to the uvula), oropharynx (from the uvula to the base of the tongue, containing the tonsils and the posterior 1/3 of the tongue), and laryngopharynx. The laryngopharynx is the lower part of the pharyngeal cavity and is also called the hypopharynx. The hypopharynx is immediately posterior to the larynx, below which is the esophageal population, between the level of the hyoid bone and the lower edge of the cricoid cartilage. The laryngopharynx is clinically divided into three anatomical regions: the pyriform fossa, the posterior cricoid region, and the posterior pharyngeal wall. Laryngopharyngeal carcinoma (hypopharyngeal carcinoma) is a malignant tumor that occurs in the laryngopharynx and is less common. Most of them occur in the pear-shaped fossa, less in the posterior pharyngeal wall, and even less in the postcircular region. The first two are mostly seen in men, while cancer in the postcircular region is mostly seen in women. The etiology of laryngopharyngeal cancer is unknown, but epidemiological studies have shown that excessive smoking and alcohol consumption may be related to the formation of laryngopharyngeal cancer. The age of prevalence of laryngopharyngeal cancer is 50-70 years old. Most of the malignant tumors in laryngopharynx are squamous cell carcinoma, and their treatment effect is poor. The current treatment method is surgery plus radiotherapy, and the 5-year survival rate after treatment is only about 40%. Laryngopharyngeal tumors are deep and hidden, and the symptoms of early laryngopharyngeal cancer are not obvious or mild, only throat discomfort and foreign body sensation, which are easily misdiagnosed as “chronic pharyngitis” and “plum pneumonia” and treated for several months. Indirect laryngoscopy is not easy to detect. Once symptoms appear, more than 60% of the patients are already in advanced stage, which is more difficult to treat and has poor prognosis. Therefore, only early detection and early treatment can improve the treatment effect of laryngopharyngeal cancer. Clinical manifestations of laryngopharyngeal cancer (1) Foreign body sensation in the pharynx: at the beginning of the disease, the patient can have foreign body sensation in the pharynx, often with food residue after eating, which can last for several months; (2) Painful swallowing: it is mild at the beginning, but gradually worsens later, and can spread to one side of the ear; (3) Dysphagia: when the tumor increases to a certain volume, it can produce dysphagia; (4) Hoarseness: in the late stage, it is caused by invasion of the larynx or laryngeal return nerve. (4) hoarseness: in advanced stage, it is caused by invasion of the intralaryngeal or laryngeal nerve. (5) Coughing or choking: the tumor grows and affects the swallowing function, saliva or food can choke into the respiratory tract; (6) Neck lump: about 1/3 of the patients come to the clinic with the complaint of neck lump, usually in the upper or middle neck, and the pharyngeal symptoms can be mild or absent. 2.Diagnosis of laryngopharyngeal cancer When the above symptoms appear, patients should go to otorhinolaryngology for detailed examination. Besides examining oropharynx, laryngoscope should be used to observe hypopharynx and larynx in detail. Tumors in the posterior cricoid region and the pyriform fossa are not easily detected, and fiberoptic laryngoscopy can help to detect hidden lesions. If laryngopharyngeal cancer is highly suspected but not detected by laryngoscopy, rigid esophagoscopy and biopsy should be performed at the same time. Lateral cervical X-ray and hypopharyngeal esophagogram with barium can observe the soft tissues in the larynx and pre-cone as well as the extent of lesion involvement. Ultrasonography can understand the lymph node metastasis in the neck. CT can assist in determining the extent of tumor and lymph node metastasis that are difficult to detect clinically. Magnetic resonance imaging can distinguish tumor and other soft tissue shadows, and can see tumor invasion in three levels in three dimensions. Treatment of laryngopharyngeal cancer The treatment plan of laryngopharyngeal cancer varies according to the clinical stage. Early stage laryngopharyngeal cancer can be treated by radiotherapy or surgery alone, and the efficacy of surgery alone is better than that of radiotherapy alone. Surgery alone is more effective than radiotherapy alone. For stage III and IV patients, comprehensive treatment is appropriate, and surgery plus radiotherapy is the most effective treatment method at present. Surgical treatment to preserve laryngeal function: Early stage patients can have local excision of the lesion and take a skin flap or myocutaneous flap to repair the defect to preserve laryngeal function. For more advanced lesions, extensive resection including the larynx should be performed. Postoperative repair and reconstruction of the laryngopharyngeal defect should be based on the patient’s specific situation to choose the most appropriate repair method. Currently, commonly used repair methods include gastric or colonic substitution of the hypopharyngeal esophagus, free forearm flap, anterolateral femoral flap, and free jejunum.