Functional Outcomes After Transoral Plus Lateral Pharyngotomy Approach for Advanced Oral and Oropharyngeal Tumors

Abstract

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.

Keywords

• head and neck cancer
• lateral pharyngotomy
• oropharyngeal cancer
• radiation therapy
• surgical salvage