Staged resection and local intralesional triamcinolone acetonide injection to prevent postoperative stricture for multiple superficial hypopharyngeal cancer : a case report

Transoral surgery and radiotherapy are the standard treatments for superficial head and neck cancer. The treatment modality should be carefully chosen based on the patient’s age, past history, tumor site, and tumor invasion depth. Here, we present the case of a 75-year-old man with a history of endoscopic treatment for superficial esophageal cancer. Multiple superficial hypopharyngeal cancers were identified in the bilateral piriform sinus and posterior wall. Instead of radiotherapy, transoral surgery was planned, due to concerns over second primary lesions and locoregional recurrences in the future. Since a wide resection was planned, the risk of dysphagia, caused by postoperative stricture, was a concern. In an effort to prevent this complication, staged resection and local intralesional triamcinolone acetonide （TA） injection was performed. The patient followed a favorable postoperative course with no adverse events. This case illustrates that staged resection and TA injection may be useful in preventing postoperative dysphagia, and thus lead to a more aggressive indication of transoral surgery.