caa a22 4500 606187618 CHVBK 20210128100841.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00405-015-3540-x doi (NATIONALLICENCE)springer-10.1007/s00405-015-3540-x Severe prolonged dysphagia following transoral resection of bilateral synchronous tonsillar carcinoma [Elektronische Daten] [Alpen Patel, Michael Hinni, Taylor Pollei, Richard Hayden, Eric Moore] Objectives: Alert the reader to the complication of severe dysphagia following transoral laser microsurgery (TLM) or transoral robotic surgery (TORS) for bilateral simultaneous or synchronous tonsillar squamous cell carcinoma. Methods: A case series of four patients treated at an academic tertiary center between 2008 and 2012 is presented; two treated with transoral laser microsurgery and two with transoral robotic surgery for biopsy-proven untreated bilateral primary squamous cell carcinoma. Main outcome measures included functional swallowing determined by the Functional Outcome Swallowing Scale. The incidence of significant postoperative complications was recorded. Results: Two patients had surgery for discontiguous involvement of bilateral palatine tonsils with squamous cell carcinoma, while two patients had surgery for bilateral tonsillar squamous cell carcinoma with unilateral extension into the base of tongue. Complete swallowing failure as characterized by the Functional Outcome Swallowing Scale was seen postoperatively in 3/4 patients who underwent TLM or TORS for bilateral simultaneous tonsillar carcinoma, while one patient was lost to follow-up. Conclusions: Severe dysphagia in the setting of bilateral oropharyngectomy for simultaneous or synchronous tonsillar squamous cell carcinoma is rarely described but a significant concern. In an era with increased use of transoral surgery as de-escalation therapy, this unusual complication warrants consideration. We report that transoral bilateral pharyngectomy is quite harmful to near-term and intermediate-term swallowing outcomes. This paper serves to provide warning against primary surgical intervention in this setting, while demonstrating that non-surgical treatment may be the best viable option. Springer-Verlag Berlin Heidelberg, 2015 Synchronous nationallicence Bilateral nationallicence Tonsillar nationallicence Dysphagia nationallicence Swallowing nationallicence Carcinoma nationallicence Transoral surgery nationallicence Oropharynx nationallicence Patel Alpen Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut Hinni Michael Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut Pollei Taylor Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut Hayden Richard Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut Moore Eric Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, USA aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/11(2015-11-01), 3585-3591 0937-4477 272:11<3585 2015 272 405 https://doi.org/10.1007/s00405-015-3540-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-015-3540-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Patel Alpen Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Hinni Michael Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Pollei Taylor Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Hayden Richard Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., 85054, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Moore Eric Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, USA aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/11(2015-11-01), 3585-3591 0937-4477 272:11<3585 2015 272 405