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Post-operative outcomes of different surgical approaches to oropharyngeal squamous cell cancer: a case-matched study

Published online by Cambridge University Press:  05 April 2021

G Tirelli ,
A Bertolin ,
F Guida ,
S Zucchini ,
M Tofanelli ,
G Rizzotto ,
P Boscolo-Rizzo ,
G Danesi  and
N Gardenal Open the ORCID record for N Gardenal [Opens in a new window]
G Tirelli
Affiliation:
ENT Clinic, Head and Neck Department, University of Trieste, Italy
A Bertolin
Affiliation:
Otolaryngology Service, Vittorio Veneto Hospital, Italy
F Guida
Affiliation:
ENT Clinic, Head and Neck Department, University of Trieste, Italy
S Zucchini
Affiliation:
ENT Clinic, Head and Neck Department, University of Trieste, Italy
M Tofanelli
Affiliation:
ENT Clinic, Head and Neck Department, University of Trieste, Italy
G Rizzotto
Affiliation:
Otolaryngology Service, Vittorio Veneto Hospital, Italy
P Boscolo-Rizzo
Affiliation:
Department of Neurosciences, Section of Otolaryngology, University of Padova, Italy
G Danesi
Affiliation:
ENT and Skull-Base Surgery Department, Department of Neurosciences, Papa Giovanni XXIII Hospital, Bergamo, Italy
N Gardenal*
Affiliation:
ENT Clinic, Head and Neck Department, University of Trieste, Italy
*
Author for correspondence: Dr Nicoletta Gardenal, ENT Clinic, Head and Neck Department, Cattinara Hospital, University of Trieste, Strada di Fiume 447, I-34149, Trieste, Italy E-mail: nicolettagardenal@gmail.com Fax: +39 040 399 4180
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Abstract

Objective

To compare the post-operative outcomes of transoral laser microsurgery, lateral pharyngotomy and transmandibular surgery in oropharyngeal cancer management.

Methods

Records of 162 patients treated with transmandibular surgery, transoral laser microsurgery or lateral pharyngotomy were reviewed. The transoral laser microsurgery cohort was matched with the lateral pharyngotomy and transmandibular surgery cohorts for tumour stage, tumour subsite and human papilloma virus status, and the intra- and post-operative outcomes were compared.

Results

Duration of surgery and hospital stay were significantly longer for transmandibular surgery. Tracheostomy and nasogastric feeding tube rates were similar, but time to decannulation and to oral feeding were longer in the transmandibular surgery group. Transmandibular surgery more frequently required flap reconstruction and had a greater complication rate. Negative margins were fewer in the lateral pharyngotomy group than in the transoral laser microsurgery and transmandibular surgery groups.

Conclusion

In comparison with transmandibular surgery, transoral laser microsurgery and lateral pharyngotomy were associated with fewer complications and faster functional recovery. Lateral pharyngotomy had a higher rate of positive margins than transoral laser microsurgery, with a consequently greater need for adjuvant therapy. Many patients are nonetheless unsuitable for transoral surgery. All these factors should be considered when deciding on oropharyngeal cancer surgical treatment.

Keywords

OropharynxOropharyngeal CancerTransoral Laser MicrosurgeryLateral Pharyngotomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 4 , April 2021 , pp. 348 - 354
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr N Gardenal takes responsibility for the integrity of the content of the paper

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