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Objective: Evaluate details of neck node metastasis (NM) and mediastinal node metastasis (MM) in carcinomas of the pharyngolaryngoesophageal (PLE) region.Method: Chart review of 44 patients with gastric pull-up for Ca of the PLE junction (cervical esophageal, hypopharyngeal and advanced laryngeal carcinomas). The mediastinal dissection (MD) resected mainly the paratracheal/paraesophageal lymph nodes down to the aortic arch.Results: Fifty neck dissections (ND) were performed in 28 patients (positive nodes in 47.7%). The NM occurred in 22.2%, 60%, 70%, and 66.6% of patients with esophageal, pyriform sinus, retrocricoid, and laryngeal carcinomas, respectively. The number of neck nodes averaged 22.8 to 27.5 nodes per ND (positive in 12.5%) and was concentrated in levels II, III, and IV (84.3%). Extra capsular invasion (IE) occurred in 80.9%. Eighteen (48.6%) out of 37 patients had MM. MM occurred in 16.6%, 47.2%, and 64.2% of the patients with laryngeal, hypopharyngeal, and esophageal Ca, respectively. MD yie...

Purpose The use of pedicled myocutaneous flaps in head and neck reconstruction is widely accepted. We describe retrospectively our experience with infrahyoid flaps (IHFs employed to cover surgical defects in the oral cavity and oropharynx in patients with benign and malignant tumors. The aim was to evaluate the success rate for infrahyoid myocutaneous flap procedures performed at a single institution. Methods Twenty-four IHF were used to reconstruct surgical defects in twenty men (83.3%) and four women (16.7%) with a mean age of 61.8 years. The anterior floor of the mouth was reconstructed in 14 patients (58.3%), the lateral floor in five (20.8%), the base of tongue in 3 (12.5%), the retro molar area and oro-posterior wall of hypopharynx in one case each (4.1%). Twenty-two patients (91.6%) had squamous cell carcinoma (SCC) and two (8.3%) ameloblastoma. Of the SCC cases, the disease stage was T3 in 14 (63.6%) and T4 in 8 (36.3%). All patients were submitted to selective unilateral or bilateral neck dissections. Results No patient presented total flap loss or fistula. The most common complication was epidermolysis, which was important in five (20.8%) patients, delaying the beginning of oral ingestion. However, oral feeding was started on average at eight days. Four (16.6%) patients required postoperative speech therapy. The patients with SCC received postoperative radiotherapy with no major consequences to the flap. Conclusions IHF is a safe and reliable procedure for reconstructing head and neck surgical defects. Due to its thinness and malleability, its use for oral cavity and oropharynx defects provides favorable cosmetic and functional outcomes. Complications, when present, are easy to manage.