Functional Outcomes After Transoral Plus Lateral Pharyngotomy Approach for Advanced Oral and Oropharyngeal Tumors
Sophia M. Colevas,
Emily C. Merfeld,
Zachary E. Pflum,
Thomas G. Gessert,
Aaron M. Wieland,
Tiffany A. Glazer,
Adam R. Burr,
Paul M. Harari,
Gregory K. Hartig
Affiliations
Sophia M. Colevas
Department of Surgery, Division of Otolaryngology–Head and Neck Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Emily C. Merfeld
Department of Human Oncology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Zachary E. Pflum
Department of Surgery, Division of Otolaryngology–Head and Neck Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Thomas G. Gessert
Department of Surgery, Division of Otolaryngology–Head and Neck Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Aaron M. Wieland
Department of Surgery, Division of Otolaryngology–Head and Neck Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Tiffany A. Glazer
Department of Surgery, Division of Otolaryngology–Head and Neck Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Adam R. Burr
Department of Human Oncology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Paul M. Harari
Department of Human Oncology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Gregory K. Hartig
Department of Human Oncology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
Abstract Objective The aim of this study was to evaluate our institutional experience with the combined transoral plus lateral pharyngotomy (TO+LP) approach in a subset of patients with advanced or recurrent oral and oropharyngeal malignancy. Study Design A retrospective study of procedures utilizing TO+LP for cancer resection between January 2007 and July 2019. Setting Tertiary academic medical center. Methods Thirty‐one patients underwent a TO+LP approach for the resection of oral and oropharyngeal tumors. Functional and oncologic outcomes were analyzed. Results Eighteen (58.1%) patients were treated with TO+LP for recurrent disease. Twenty‐nine required free tissue transfer and 2 (6.5%) had positive margins. The median time to decannulation was 22 days (range 6‐100 days). Thirteen (41.9%) patients still required enteral feeding at their most recent follow‐up. Patients without a history of prior radiation were decannulated sooner (p = .009) and were less likely to require enteral feeding at the first postoperative follow‐up (p = .034) than those who had prior head and neck radiotherapy. Conclusion A TO+LP approach can be used to achieve good functional and oncologic results for selected patients with advanced or recurrent oral and oropharyngeal cancer when minimally invasive options such as transoral robotic surgery, transoral laser microsurgery, or radiotherapy are not possible.
