Transoral resection of oropharyngeal carcinoma is safe, and severe life-threatening hemorrhage is rare. Although transcervical vessel ligation did not result in an overall decrease in bleeding rate, there is a trend toward reduced postoropharyngectomy bleeding severity with ligation. We recommend ligation for higher T-stage tumors, primary tonsil tumors, and patients undergoing revision surgery.

Oral Presentations P33and Neck Surgery were analyzed. The sample included fellows of the AAO-HNS practicing within the US and graduating from residency programs accredited by the ACGME. First year fellows, fellows of greater than thirty-five years, and military fellows were excluded. Data from 5,870 otolaryngologists were analyzed. To evaluate trends within generations and career paths, subsets were divided by academic or nonacademic practice and by decade of completion of residency.

Resident participation in the operating room results in increased surgical length and additional system cost. Although residency is a necessary part of surgical training, associated costs need to be acknowledged.

Severe dysphagia in the setting of bilateral oropharyngectomy for simultaneous or synchronous tonsillar squamous cell carcinoma is rarely described but a significant concern. In an era with increased use of transoral surgery as de-escalation therapy, this unusual complication warrants consideration. We report that transoral bilateral pharyngectomy is quite harmful to near-term and intermediate-term swallowing outcomes. This paper serves to provide warning against primary surgical intervention in this setting, while demonstrating that non-surgical treatment may be the best viable option.

In the treatment of isolated CPH or ZD, stapler-assisted endoscopic surgery results in a shorter operative time, whereas laser-assisted CPM results in a decreased incidence of symptomatic recurrence.

Intraoperative plain film imaging during cochlear implantation, although commonly employed, does not typically affect clinical management. For select cases, imaging may continue to be useful based on the surgeon's discretion and intraoperative findings for confirmatory purposes.

This is the second of the three articles discussing volumetric rejuvenation of the face. The previous article, Volume Rejuvenation of the Facial Upper Third, focused on the upper one-third of the face while this article focuses on the middle one-third, primarily the lower eyelid, cheek, and perioral area. Again, the authors (RG, TK, SPS, RF, SL, and EFW) from the upper face article have provided a summary of rejuvenation utilizing a product of which they are considered an expert. Robert Glasgold has provided volumetric analysis of the region as an introduction.

Objectives: 1) Describe the complication of severe dysphagia following transoral surgical resection for bilateral simultaneous or synchronous tonsillar squamous cell carcinoma. 2) Analyze the incidence of bilateral simultaneous or synchronous tonsillar squamous cell carcinoma, as well as tumor multifocality in the setting of human papillomavirus. Methods: A retrospective review of four patients who presented to an academic, tertiary referral center between 2008-2012 were reviewed; two treated with transoral laser microsurgery (TLM) and two with transoral robotic surgery (TORS) for biopsy proven previously untreated bilateral primary squamous cell carcinoma (SCCA). Main outcome measures included functional swallowing determined by the Functional Outcome Swallowing Scale (FOSS). The incidence of significant postoperative complications was recorded. Results: Two patients had surgery for discontiguous involvement of bilateral palatine tonsils with SCCA, while two patients had surgery for bilateral tonsillar SCCA with unilateral extension into the base of tongue. Complete swallowing failure as characterized by the FOSS was seen postoperatively in 3/4 patients who underwent TLM or TORS for bilateral simultaneous tonsillar carcinoma, while one patient was lost to follow-up. Conclusions: Severe dysphagia in the setting of bilateral oropharyngectomy for simultaneous or synchronous tonsillar SCCA is rarely described but a significant concern. In an era with increased use of transoral surgery, along with increased human papillomavirus incidence, this unusual complication warrants discussion.