Objectives: Robotic transoral mucosectomy of the base of tongue was introduced as a diagnostic procedure in patients treated for head and neck cancer with unknown primary (CUP), increasing the identification rate of the primary tumour. For the treatment of CUP, a considerable percentage of patients require adjuvant (chemo)radiation. The aim of this study was to investigate swallowing outcomes among CUP patients after TORS and adjuvant treatment.
Subjects And Methods: A systematic review was carried out on studies investigating the impact of TORS and adjuvant treatment on swallowing-related outcomes among CUP patients In addition, a cross-sectional study was carried out on swallowing problems (measured using the SWAL-QOL questionnaire) among CUP patients in routine care who visited the outpatient clinic 1-5 years after TORS and adjuvant treatment.
Results: The systematic review (6 studies; n = 98) showed that most patients returned to a full oral diet. The cross-sectional study (n = 12) showed that all patients were able to return to a full oral diet, nevertheless, 50% reported swallowing problems in daily life (SWAL-QOL total score ≥14).
Conclusion: Although after TORS and adjuvant treatment for CUP a full oral diet can be resumed, patients still experience problems with eating and drinking in daily life.
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http://dx.doi.org/10.1111/odi.15063 | DOI Listing |
Head Neck
December 2024
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, School of Communication, Evanston, Illinois, USA.
Background: Dysphagia (difficulty swallowing) is a common morbidity resulting from the treatment of head-and-neck squamous-cell carcinoma (HNSCC) due to surgery and chemoradiation. Transoral robotic surgery (TORS) is a minimally invasive surgical technique for the management of HNSCC, which ideally avoids many of the known complications of open surgery. Research describing physiologic swallowing impairment after surgery using videofluoroscopy is lacking.
View Article and Find Full Text PDFLaryngoscope
December 2024
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Objective: Transoral robotic surgery (TORS) has shown promising results in treating human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC), and there has been increasing interest in incorporating neoadjuvant chemotherapy (NCT) prior to TORS. This study aimed to assess the feasibility and safety of sparing adjuvant RT following NCT and TORS.
Methods: A retrospective cohort study included consecutive patients with HPV-positive OPSCC who underwent NCT followed by TORS without adjuvant RT.
Oral Oncol
December 2024
Department of Microbiology, Centre for Infectious Diseases, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University (Deemed to be University), Chennai 600 077, Tamil Nadu, India.
The study finds no significant difference in the timing of radiation therapy initiation between bleeding and non-bleeding cohorts, ensuring that timely adjuvant care is achievable without compromising survival. Feeding tube dependency and dysphagia outcomes are also explored to enhance understanding of post-surgical morbidity and quality of life. With a multi-institutional design, the study strengthens the generalizability of its findings and addresses limitations inherent in retrospective data collection.
View Article and Find Full Text PDFJ Clin Med
October 2024
Otolaryngology Head and Neck Unit, "Santo Spirito" Hospital, 65124 Pescara, Italy.
Transoral robotic surgery (TORS) is nowadays considered a valuable minimally invasive approach to treat oropharyngeal squamous cell carcinoma (OPSCC). The aim of this technique is to improve functional preservation and reduce morbidity with excellent oncologic outcomes compared to the traditional transoral approach and chemoradiotherapy (CRT). The purpose of this systematic review is to assess an exhaustive overview of functional outcomes of TORS for OPSCC by evaluating several parameters reported in the available literature, such as the prevalence and dependence of tracheotomy, feeding tubes (FTs) and percutaneous endoscopic gastrostomy (PEG), the length of hospitalization, swallowing scores, speech tests and quality of life (QoL) questionnaires.
View Article and Find Full Text PDFJAMA Otolaryngol Head Neck Surg
October 2024
Liverpool Head and Neck Centre, University of Liverpool, Liverpool, United Kingdom.
Background: Transoral robotic surgery (TORS) or transoral laser microsurgery (TLM) offer excellent oncological outcomes for oropharyngeal squamous cell carcinoma caused by human papillomavirus (HPV) infection. TORS may offer greater margin clearance around tumors than TLM.
Objective: To determine whether the differing energy sources used and surgical technique of TORS or TLM is associated with postoperative early swallowing function, feeding tube use, and specific factors related to quality of life.
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