Abstract
OBJECTIVE: To evaluate the therapeutic efficacy, long-term outcomes, and clinical applicability of partial laryngeal preservation surgery via the paraglottic space approach in the treatment of hypopharyngeal malignancies originating from the postcricoid region. METHODS: This retrospective observational study included patients diagnosed with hypopharyngeal squamous cell carcinoma originating specifically from the postcricoid region, who underwent surgical treatment at Qilu Hospital of Shandong University and West China Hospital of Sichuan University between July 2017 and April 2025. Clinical data related to tumor resection and laryngeal function reconstruction were analyzed. Key outcome measures included postoperative decannulation rates, long-term recurrence and metastasis rates, survival status, as well as respiratory and swallowing function scores. RESULTS: All patients were followed for a minimum of five years. Four patients remained tracheostomy-dependent, including one patient who exhibited no dyspnea following tube occlusion. The overall decannulation rate was 63.64%, with all successful decannulations occurring after radiotherapy. Oral feeding was initiated at a mean of 20.73 ± 4.05 days postoperatively, with nasogastric tube removal occurring after an average of 2.18 ± 0.94 days of swallowing rehabilitation. The mean scores for both swallowing and phonation function were 1.36. The 5-year overall survival rates was 70.1%. CONCLUSION: Partial laryngeal preservation surgery via the paraglottic space approach is a relatively safe and feasible treatment option for hypopharyngeal carcinomas originating from the postcricoid region. This technique enables effective oncologic control while preserving essential laryngeal functions, making it a valuable option for clinical application and broader adoption. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-026-03586-9.