Objective: To evaluate the efficacy of curved
suspension laryngoscope assistant transoral surgery (CLATOS) in the examination of hypopharynx, and diagnosis and surgery of early hypopharyngeal
carcinoma. Methods: Thirty-four patients who underwent detailed examination for lower part of hypopharynx and surgery for early hypopharyngeal
carcinoma with CLATOS technique in the Second Affiliated Hospital of Harbin Medical University from January 2019 to January 2020 were analyzed retrospectively. The age ranged from 42 to 74 years old including 28 males and 6 females. Among them, 25 patients complaining of
foreign body sensation in the pharynx for more than half a year with a poor exposure of the lower pharynx in the examination with flexible
laryngoscope in the outpatient department were admitted to the hospital for the further examination with rigid curved laryngoscopy and 9 patients with stage T1-2
hypopharyngeal squamous cell carcinoma were operated with CLATOS technique. Preoperative, intraoperative and postoperative data were analized. Results: One case of
squamous cell carcinoma in esophageal entrance (T1N0M0) and one case of
carcinoma in pyriform sinus (T1N0M0) with cervical esophageal
carcinoma (T1N0M0) were found in the 25 patients with
foreign body sensation in the pharynx. En bloc resection of
cancer was obtained in 9 patients with stage T1-2 hypopharyngeal
carcinomas and 2 of them underwent
tracheotomy. One patient with T1 retrocricoid
carcinoma was found to have a
carcinoma in situ at the lower part of posterior hypopharyngeal wall in the examination during follow-up, which was resected simultaneously. Postoperatively this patient developed a
stenosis in the esophageal entrance, which was dilated twice until swallowing normally. Two patients of T2N0M0 and one of T2N1M0 underwent bilateral neck
lymph node dissection just after the removal of primary
tumors. During follow-up, none of the 9 patients showed
tumor recurrence and complications such as
dysphonia and
dyspnea. Conclusion: CLATOS technique can provide a promising way in the examination of hypopharynx and the detection of early lesions of hypopharynx and esophageal entrance, and this technique has also the advantages such as full visual angle and easy operation for the resection of early hypopharyngeal
carcinoma. The quality of life of patients can be improved while the
tumor is removed en bloc with this technique.