First Bite Syndrome in Transoral Surgery for Oropharyngeal Cancer.

Autor: Wistermayer PR; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA., Brown AE; M.D. Program, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA., Cave TB; 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., Chang BA; 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., Hinni ML; 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: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2024 Jul; Vol. 171 (1), pp. 146-154. Date of Electronic Publication: 2024 Apr 21.
DOI: 10.1002/ohn.781
Abstrakt: Objective: First bite syndrome (FBS) is a rare complication of transoral surgery (TOS) for oropharyngeal cancer (oropharyngeal squamous cell carcinoma [OPSCC]). Risk factors for developing this complication are not well described. In this study, we attempt to identify risks for developing FBS in TOS.
Study Design: Retrospective chart review.
Setting: Tertiary care medical center.
Methods: This study was exempted by the Mayo Clinic institutional review board. We performed a review from January 2017 to November 2022 of all patients who underwent TOS for OPSCC by a single provider. Exclusion criteria included less than 6 months follow up, prior treatment of head and neck cancer, or incomplete records. Demographic data, comorbidities, tumor characteristics, surgical details, adjuvant treatment details, functional outcomes, and oncologic outcomes were assessed. Fisher's Exact test and Kruskal-Wallis rank sum test were used to identify significant variables, and multivariable logistic regression was used to address confounding.
Results: One hundred and one patients were identified. Eighty-nine met the inclusion criteria. The mean follow-up was 34 months (median 33). Seven patients (7.9%) developed FBS. Palatine tumor primary (P = .041), resection of styloglossus/stylopharyngeus (P = .039), and parapharyngeal fat manipulation (P = .015) were associated with the presence of FBS. After adjusting for tumor location, manipulation of parapharyngeal fat maintained significance (P = .025). T and N staging, tumor volume, adjuvant radiation, and ligation of lingual/facial arteries were not associated with the development of FBS. Eighty-six percent (6/7) of patients had a resolution of FBS at an average of 11.3 months.
Conclusion: Manipulation of the parapharyngeal space is independently associated with developing FBS in TOS in our cohort. Further confirmatory studies are warranted.
(© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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