Postoperative data of patients
All patients were followed up for 5 years. Six patients were lost by the end of follow-up. Survival analysis was performed in accordance with the final follow-up time. The follow-up time was 6–82 months, and the median follow-up time was 50 months. The patients who lost follow-up participated in the survival analysis as censored data, and the survival time was calculated according to the last follow-up time before the loss of follow-up. The postoperative pathology of all patients was squamous cell carcinoma. The metastasis rate of lateral cervical lymph nodes was 74.2% (69/93). Seventy patients underwent level VI lymph node dissection and retropharyngeal lymph node dissection. The positive rates of region VI lymph nodes and retropharyngeal lymph nodes were 12.9% (9/70) and 15.7% (11/70), respectively.
A total of 78 patients in this group had their larynges preserved. 11 patients underwent tongue root flap repair, 20 patients underwent pectoralis major myocutaneous flap repair, and 5 patients underwent subchin flap repair. Other patients performed local mucosal flap repair of pharyngeal defects.
Pathological examination revealed that 81 patients (87%) had negative tumor margins without lesions. Twelve cases had positive or poorly defined margins microscopically, and in these cases, the margins of the frozen sections were expanded until the margins were negative.
By postoperational laryngeal function evaluation methods such as subjective sensation, voice quality,electronic laryngeal endoscopy, and X-ray barium meal examination, 65.6% (61/93) cases showed complete recovery of laryngeal functions (speech,respiration, and deglutition). shown in Table 3.
Tracheal cannula removal time. Amongst the 78 patients with laryngeal preservation, 63 patients were extubated after radiotherapy. Unfortunately, 2 patients underwent tracheotomy and intubation again with laryngeal edema.
During the perioperative period, four cases had internal pharyngeal fistula, two cases experienced subcutaneous effusion, and one case experienced bleeding at the tracheotomy, all of which were cured by dressing change and pressure bandaging. One case of pulmonary infection improved after switching to sensitive antibiotics. No death occurred during the perioperative period.