Long-term functional swallowing and speech outcomes after transoral
robotic surgery for oropharyngeal cancer
Abstract
Objective: Transoral robotic surgery (TORS) for oropharyngeal cancer was
introduced to ensure better functional preservation with less morbidity.
However, long-term functional outcomes, especially speech and swallowing
outcomes, have not been thoroughly investigated. This study aimed to
evaluate the long-term functional swallowing and speech outcomes after
transoral robotic surgery for oropharyngeal cancer. Methods We studied
41 patients with oropharyngeal squamous cell carcinoma who underwent
TORS between January 2010 and December 2018. Tongue mobility, maximal
phonation time, articulation, verbal diadochokinesis, reading speed, and
modified barium swallowing tests were performed between two and three
years after TORS to analyze the long-term functional speech and
swallowing outcomes. Results: The mean patient age was 57.7 ± 9.9 years,
and the male to female ratio was 34:7. The most common subsite was the
palatine tonsil (73.2%), followed by the base of tongue (22.0%). Forty
patients (97.6%) underwent concomitant neck dissection, and 36 patients
(87.8%) received adjuvant radiation or chemoradiation therapy. Tongue
mobility, maximum phonation time, articulation, verbal diadochokinesis,
and reading speed were not different from those of the normal
population. Modified barium swallowing outcomes were acceptable in most
patients; however, one patient (2.4%) was dependent on a percutaneous
endoscopic gastrostomy tube. None of the patients required a permanent
tracheostomy. Conclusions: Long-term speech and swallowing functions
after TORS were acceptable in most patients with oropharyngeal cancer.
TORS is an excellent treatment modality for oropharyngeal cancer in
terms of functional outcomes.