Recent advances in laryngo, pharyngo, esophageal reconstruction.

Laryngopharyngeal reconstruction has remained a challenging field since the performance of the first laryngectomy near the turn of the century. Cutaneous, myocutaneous and colonic reconstruction is still occasionally used but is fraught with a high stenosis and fistula rate. Gastric pull-up has remained the procedure of choice for single staged pedicled reconstruction.

Screening for distant metastases in head and neck cancer patients.

The search for distant metastases in head and neck cancer patients, at the time of initial presentation and evaluation, is justified in order not to subject a patient to radical local therapy if cure cannot be attained. This study reviews 897 consecutive cases of squamous carcinoma of the larynx, oropharynx, hypopharynx and oral cavity, presenting to the Department of Otolaryngology--Head and Neck Surgery. One hundred and twenty-one patients presented with advanced disease or other factors that suggested distant metastases were highly likely to be present.