الفهرس 
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Abstract
According to reported data about these patients, the post cricoid region is the most presentable site (16.7%) followed by piriform fossa (10.4%) then post. Pharyngeal wall site (10.4%) in cases with cancer hypopharynx. Also the supraglottic area is the most affected among these patients (33.3%), then glottic area (18.8%), then subglottic area (10.4%) in those with cancer larynx. Most patients presented with T2 & T3 stages about (66.6%) and N1 & N2 stages about (68.7 %) which in proportion affect the post-operative sequel for these patients. Squamous cell carcinoma is the predominant in post-operative histopathological evaluation (89 %) while adenocarcinoma in only one case (2%). In our institute, three types of pharyngeal reconstruction were performed with primary closure of the pharynx after total laryngectomy in 25 patients (52.1%), while PMMF reconstruction after total laryngectomy with circumferential pharyngeal defect in 5 patients (10.4%), also gastric pull up reconstruction after total laryngopharyngectomy in 18 patients (37.5%). With analysis our post-operative data showed that with primary closure of the pharynx there was increased complications as regard PCF (6 cases) & pharyngeal stenosis (3 cases) & wound infection (6 cases) & pulmonary complications (3 cases) followed by gastric pull up reconstruction as regard PCF (2 cases) & pharyngeal stenosis (3 cases) & wound infection (4 cases) & pulmonary complications (4 cases) and the least post-operative complications with PMMF reconstruction as regard PCF (2 cases) & pharyngeal stenosis (1 case) & wound infection (2 cases) & pulmonary complications (1 case). Neck dissection in cases of cancer larynx and hypopharynx is crucial and must be bilateral in all cases as 7 cases in our study didn’t underwent neck dissection so presented later with recurrent cervical lesions about after 6 months which adversely affect the disease free & overall survival. In this study, there was strong evidence that the use of chemoradiation was important for these patients as it increases the disease free & overall survival time (mean survival time = 79.5 months) comparatively to those not received (mean survival time = 23.3 months) but the incidence of post-operative complications was also increased among those received chemoradiation. from the present study it could be concluded that: The use of suitable reconstructive method of the pharynx post laryngectomy or post laryngopharyngectomy is mainly depend on fulfillment the criteria for each method which give the best results for patients as regard function, cosmetic results and disease free & overall survival. The use of Fasciocutaneous flap reconstruction is better option for pharyngeal reconstruction that underwent resection of the pharynx with circumferential pharyngeal defect and those received prior chemoradiation to surgical intervention with better postoperative aesthetic, functional and oncological results and gastric pull up transposition is better when the primary lesion extend to the oesphagus. Bilateral neck dissection is indicated in cases with hypopharyngeal and laryngeal cancers as affects disease free and overall survival.