Abstract
Objective
Soft tissue necrosis (STN) can occur after transoral robotic surgery (TORS) with radiation
therapy (RT). We investigated the usefulness of local flap reconstruction for preventing
STN after TORS in patients with tonsillar cancer.
Methods
This case-control study retrospectively reviewed clinicopathological data of patients
who underwent TORS for tonsillar cancer at a tertiary referral center. The incidence
of STN was compared in patients who underwent secondary intention healing or local
flap reconstruction, and factors predicting STN were identified.
Results
STN occurred in 20 (25%) of 80 patients in the study. The incidence of STN was higher
in the secondary intention healing than the flap reconstruction group. Mucositis grade
(odds ratio [OR] 3.694, p = 0.02), RT dose (OR 4.667, p = 0.001), and secondary intention
healing (OR 14.985, p = 0.035) were predictive factors for STN.
Conclusion
Flap reconstruction can prevent STN after TORS with RT in patients with tonsillar
cancer. The use of local flaps preserves the minimally invasive nature of TORS.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Auris Nasus LarynxAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- NCCN Practice Guidelines for head and neck cancers.Oncology (Williston Park). 2000; 14: 163-194
- Transoral robotic surgery for oropharyngeal cancer: long-term quality of life and functional outcomes.JAMA Otolaryngol Head Neck Surg. 2013; 139: 1099-1108
- Oncologic, functional and surgical outcomes of primary Transoral Robotic Surgery for early squamous cell cancer of the oropharynx: a systematic review.Oral Oncol. 2014; 50: 696-703
- Functional outcomes, feasibility, and safety of resection of transoral robotic surgery: single-institution series of 35 consecutive cases of transoral robotic surgery for oropharyngeal squamous cell carcinoma.Head Neck. 2015; 37: 1618-1624
- Role of primary closure after transoral robotic surgery for tonsillar cancer.Auris Nasus Larynx. 2015; 42: 43-48
- Primary surgery versus (chemo)radiotherapy in oropharyngeal cancer: the radiation oncologist's and medical oncologist's perspectives.Curr Opin Otolaryngol Head Neck Surg. 2015; 23: 139-147
- Late consequential surgical bed soft tissue necrosis in advanced oropharyngeal squamous cell carcinomas treated with transoral robotic surgery and postoperative radiation therapy.Int J Radiat Oncol Biol Phys. 2014; 89: 981-988
- Soft tissue necrosis in head and neck cancer patients after transoral robotic surgery or wide excision with primary closure followed by radiation therapy.Medicine (Baltimore). 2016; 95: e2852
- Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: I. Technique, complications, and functional results.Arch Otolaryngol Head Neck Surg. 2005; 131: 583-591
- Reconstructive algorithm and classification system for transoral oropharyngeal defects.Head Neck. 2014; 36: 934-941
- Mechanisms of radiation-induced normal tissue toxicity and implications for future clinical trials.Radiat Oncol J. 2014; 32: 103-115
- Reconstruction of transoral robotic surgery defects: principles and techniques.J Reconstr Microsurg. 2012; 28: 465-472
- The reconstructive options for oropharyngeal defects in the transoral robotic surgery framework.Oral Oncol. 2017; 66: 108-111
Article info
Publication history
Published online: December 25, 2022
Accepted:
December 16,
2022
Received:
August 12,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V.
