Patient-Perceived and Objective Functional Outcomes Following Transoral Robotic Surgery for Early Oropharyngeal Carcinoma

Abstract

Objective The aim of this study was to develop a predictive model of objective oropharyngeal obstructive sleep apnea (OSA) surgery outcomes including success rate and apnea-hypopnea index (AHI) reduction ratio in adult OSA patients. Study design Retrospective outcome research. Methods All subjects with OSA who underwent oropharyngeal and/or nasal surgery and were followed for at least 3 months were enrolled in this study. Demographic, anatomical [tonsil size (TS) and palate-tongue position (PTP) grade (Gr)], and polysomnographic parameters were analyzed. The AHI reduction ratio (%) was defined as [(postoperative AHI-preoperative AHI) x 100 / postoperative AHI], and surgical success was defined as a ! 50% reduction in preoperative AHI with a postoperative AHI < 20.

Transoral Robotic Surgery Alone for Oropharyngeal Cancer

“…This difficulty was followed by statistically significant recovery to a higher level of function with long-term follow-up (chewing: P = .048 at 12 months; swallowing: P = .047 at 6 months and stable at 24 months; P = .048), confirming a previous finding in a small number of patients receiving TORS alone. 9 This recovery is not unexpected; previous studies [8][9][10][11]16,17 suggested that RT and CRT cause substantial deterioration in short-term and long-term patientperceived swallowing function, with slow recovery. Our study included 2 patients (6%) who had recurrences, both of whom did not adhere to recommendations for adjuvant therapy.…”

Functional outcomes after TORS for oropharyngeal cancer: a systematic review

“…Tracheostomy, typically required for airway management after open resection, is also avoided in most (70% to 100%) TORS cases, regardless of adjuvant therapy. 10,11 Finally, proponents of a primary surgical approach with TORS cite the potential to de-escalate radiotherapy to postoperative doses, or to avoid concomitant chemotherapy or radiotherapy altogether as a major functional advantage of TORS. Collectively, published series suggest that 9% to 27% of patients treated with frontline TORS avoid postoperative radiotherapy, and 34% to 45% avoid chemoradiotherapy.…”

“…Collectively, published series suggest that 9% to 27% of patients treated with frontline TORS avoid postoperative radiotherapy, and 34% to 45% avoid chemoradiotherapy. 10–14 These advantages are proposed to preserve swallowing function in properly selected patients treated with TORS. A number of authors have reported functional outcomes of TORS for OPC, but these data have not been comprehensively summarized.…”

Trans-oral robotic surgery and surgeon-performed trans-oral ultrasound for intraoperative location and excision of an isolated retropharyngeal lymph node metastasis of papillary thyroid carcinoma

“…However, relatively few studies provide details of the specifics of their post-operative swallowing dysfunction apart from gastrostomy tube dependence. Those studies that provide results using validated swallowing indices are reports concerning the treatment of oropharyngeal carcinoma with and without adjuvant therapy [23][24][25][26]. As such, it is difficult to draw a correlation between these series and extrapolate to our single patient's post-operative swallowing function.…”