Effect of palatine tonsil tumor resection on postoperative velopharyngeal insufficiency in transoral surgery.

Autor: Wistermayer PR; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA., Brown AE; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA., Cave TB; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA., Chang BA; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA., Hinni ML; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA., Hayden RE; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA., Klusovsky LE; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA., McGary A; Quantitative Health Science Research, Mayo Clinic, Phoenix, Arizona, USA., Nagel TH; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 May; Vol. 46 (5), pp. 1178-1188. Date of Electronic Publication: 2024 Mar 20.
DOI: 10.1002/hed.27741
Abstrakt: Background: Velopharyngeal insufficiency (VPI) is a known complication of transoral surgery (TOS) for oropharyngeal HPV-mediated squamous cell carcinoma. Controversy exists regarding adequate resection margins for balancing functional and oncologic outcomes.
Methods: This retrospective study was exempted by the IRB. Patients who underwent TOS from January 2017 to October 2022 were included. Patient characteristics, treatment details, and oncologic and functional outcomes were evaluated.
Results: Fifty-five patients were included. Mean and median follow-up was 34 months. 98% of patients were AJCC stage I/II. Recurrence-free survival was 96% with no local recurrences. Univariate analysis demonstrated an association between VPI and pT stage (p = 0.035), medial pterygoid resection (p = 0.049), and palatal attachment sacrifice (p < 0.001). Multivariate analysis showed sacrifice of the palatal attachments remained a significant risk for VPI (p = 0.009).
Conclusion: Loss of soft palate pharyngeal attachments is an independent risk factor for VPI. When oncologically appropriate, the palatal attachments to the pharynx may be preserved.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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