History & Examination for Hypopharyngeal Cancer

Objectives

  • Select appropriate surgery
  • Avoid unnecessary surgery
  • Avoid embarking on surgery that is beyond the scope of a surgeon

Primary tumour

  • Site
    • Hypopharynx (subsite: lateral, medial pyriform, postcricoid)
    • Supraglottis
    • Glottis
    • Vallecula/BOT
    • Distant extent (may require flap reconstruction, oesophagectomy)
  • T-stage
    • Vocal cord mobility
    • Cartilage invasion
    • Extension to oropharynx, oesophagus
  • Mobility related to
    • Prevertebral tissues
    • Thyroid cartilage
  • Laryngeal dysfunction: Stridor, voice, swallowing, aspiration

Cervical nodes

  • Palpate the neck
  • Consider Ultrasound

Synchronous Primary (upper aerodigestive tract, lungs)

  • Upper aerodigestive tract, oesophagus, lungs
  • History and office examination
  • Panendocopy
  • CXR / CT / PET

 

Index: Clinical Practice Guidelines for Hypopharyngeal Cancer

Resource Appropriate Hypopharynx Cancer Guideline Scenarios