Hypo pharynx Flashcards
exception to hypo pharynx cancer being considered more common in men
posterior cricoid is more common in women than men
causes of hypo pharynx cancer
alcohol smoking and plummer vision syndrome can occur in people with long-term iron deficiency anemia; it causes difficulty swallowing due to small, thin growth called an esophageal web- blocks the esophagus
hypo pharynx is the —–and ____ part of the pharynx
lowest and inferior
hypo pharynx extends from —- to ——–
hyoid bone end epiglottis to post of the cricoid cartilage
t levels the hypo pharynx is located between
c3-c6
hypo pharynx connects ——to ———-
oropharynx to thoracic inlet
shape of hypopharynx
horseshoe due to the indent made by the larynx
divisions of the hypo pharynx
It is subdivided into 4 parts: the lateral sides of the ‘horseshoe’ are referred to as the ——–, the posterior border forms the ————and the———- which extends from the level of the hyoid bone to the inferior border of the cricopharyngeus muscle
pyriform sinuses
postcricoid region
posterolateral pharynx
which hypo pharynx tumours do NOT qualify for voice sparing surgery
pyriform fossa apex or postcricoid area
lymphatics involved in the piriform fossa
jugulodigastric, retropharyngeal, jugulo-omohyoid, paratracheal
lymphatics involved in the posterior cricoid
jugulodigastric LN
LYMPHATICS INVOLVEDD IN THE POSTERIOR PHARYNX
: jugluodigastric, retropharyngeal
MOST COMMON HISTOPATHOLOGY HYPOPHARYNX
SCC
TNM staging hypopharynx
T1-limited to 1 subset or <2cm T2-1 subset or 2-4 cm T3->4cm or extension into the esophagus T4a- Invades thyroid/cricoid cartilage, hyoid bone, thyroid gland or central compartment of soft tissue T4-bInvades prevertebral fascia, encases carotid artery or involves mediastinal structures N1- mets in 1 single ipsilateral Ln <3CM n2-METS IN IPSILATERAL lN 3-6CM N3-Mets >6cm
stages for hyoppharynx cancer
stage1- T1N0 stage 2 T2,N0 stage3 T1,N1,M0 T2,N1,M0, T3N0M0, T3,N1,M0 stage 4 T4,N0,M0 Any T N2,N3,MO Any T ANY n M1
most common subsides to least common sub sites of hypo pharynx cancer
pyriform fossa, postcricoid, hypopharyngeal wall
________ tumours spread to involve the aryepiglottic folds; they sometimes invade medially and deeply into the false vocal cords and larynx via the paraglottic space- this allows it to behave as a transglottic carcinoma
medial pyriform fossa
____________ commonly invade the thyroid cartilage and less commonly the cricoid cartilage
lateral wall and apex of the piriform fossa
_____________tumours invade the cricoid cartilage, interarytenoid space and posterior cricohyoid muscle to produce hoarseness
post cricoid cartilage
Areas of distant mets for hypo pharynx cancer
lungs is most common then bone and brain
hallmark of postcricoid cartilage tumours presentation wise?
dysphagia
Late symptoms of hypo pharynx cancer
dysphagia and weight loss
most common and less common symptoms of hypo pharynx cancers
most common: ore throat, odynophagia (painful swallowing), pain in the ipsilateral ear, and a neck mass which may be associated with salivary drooling, stiff neck and a ‘hot potato’ voice
Less common: hoarseness, blood-streaked saliva, airway obstruction, halitosis (bad breath) and nasal voice
prognostic indictors hypo pharynx cancer
gender: better prognosis in women
age: survival better for younger patients
+ surgical margins = worse prognosis
location: decreasing in survival are: pyriform sinus, pharyngeal walls and postcricoid region **poorest results seen with pyriform apex, postcricoid and two or three wall tumours
neck mets= poor prognosis
