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- Title
Transoral robotic surgery with free flap reconstruction: Functional outcomes of 241 patients at a single institution.
- Authors
Kaki, Praneet C.; Lam, Doreen; Sangal, Neel R.; Rajasekaran, Karthik; Chalian, Ara C.; Brody, Robert M.; Weinstein, Gregory S.; Cannady, Steven B.
- Abstract
Background: Transoral robotic surgery (TORS) for oropharyngeal malignancy optimizes oncologic outcomes while preserving functionality. This study identifies patterns of functional recovery after TORS with free flap reconstruction (FFR). Methods: Retrospective cohort study at a tertiary care center of patients with primary oropharyngeal tumors treated with TORS with FFR between 2010 and 2022. Patients were categorized into: adjuvant chemoradiation or radiation, or no adjuvant therapy (NAT). Functional outcomes were measured by functional oral intake scale (FOIS). Results: 241 patients were included. FOIS declined at first postoperative appointment (median = 7.0 to 2.0, IQR = [7.0, 7.0], [2.0, 4.0]), and progressively improved to 6.0 (5.0, 6.0) after 1 year, with NAT having the highest FOIS (7.0, p < 0.05). Predictors of poor long‐term FOIS included RT and hypoglossal nerve (CN XII) involvement (p < 0.05). Conclusions: TORS with FFR leads to good long‐term function with minimal intake restrictions. Radiation therapy and CN XII involvement increase risk of worse functional outcomes.
- Subjects
SURGICAL robots; FREE flaps; FUNCTIONAL status; HYPOGLOSSAL nerve; RADIOTHERAPY
- Publication
Head & Neck, 2024, Vol 46, Issue 7, p1601
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.27761