하인두암 수술적 치료와 연하장애

Abstract

Hypopharyngeal cancer is an aggressive malignancy that is often diagnosed at an advanced stage, requiring an extensive surgical resection and complex reconstruction. Although surgery remains a cornerstone of curative management, significant postoperative dysphagia frequently occurs due to anatomical disruption, neuromuscular impairment, and altered physiology of swallowing. Understanding the mechanisms and rehabilitation strategies for dysphagia is essential for optimizing the postoperative function and quality of life. The surgical approaches for hypopharyngeal cancer include partial or total laryngopharyngectomy, depending on the tumor extent and organ preservation feasibility. These procedures inevitably damage the pharyngeal constrictors, laryngeal elevation mechanism, and upper esophageal sphincter opening, leading to impaired bolus transit and a high risk of aspiration. Moreover, loss of sensory innervation and the replacement of native pharyngeal muscle with non-contractile flap tissue further aggravate the swallowing dysfunction. Dysphagia following the surgical treatment of hypopharyngeal cancer arises from multifactorial causes related to the resulting anatomical, neurological, and reconstructive changes. Early assessment, individualized rehabilitation, and coordinated multidisciplinary care are fundamental to restoring safe and efficient swallowing. Future research should focus on improving reconstructive techniques and developing evidence-based rehabilitation protocols to enhance the postoperative quality of life.