Abstract
Introduction: Transoral surgery has been developed as a minimally invasive surgical option of an organ-function preservation strategy for patients with pharyngolaryngeal cancer. However, if resection of the tumor results in widespread damage to pharyngeal mucosa, there is concern about food swallowing dysfunction due to cicatricial pharyngeal stenosis. We report on two cases in which pharyngeal stenosis was prevented by local injection of triamcinolone acetonide after transoral resection of pharyngeal carcinoma, along with its technique and usefulness.
Case presentation: Following transoral resection of the pharyngeal tumors in a patient with hypopharyngeal carcinoma and another patient with oropharyngeal and hypopharyngeal carcinomas, we injected triamcinolone acetonide （KenacortⓇ） solution into the residual submucosal layer of the wounds using a needle equipped with a flexible tube. Postoperative endoscopic observation found no obvious stricture in the hypopharynx in both patients. Furthermore, videofluorography for swallowing tests showed neither reflux to the nasopharynx nor difficulty in passage to the esophagus in both patients.
Conclusions: We showed the usefulness of local injection of triamcinolone acetonide, which has anti-inflammatory and fibrosis-inhibitory effects, for preventing postoperative pharyngeal stenosis in cases with a large pharyngeal mucosal defect after transoral resection of pharyngeal tumors, as already shown in esophageal superficial cancer.
