Limitations of the study
This study has some limitations. First, the design was retrospective in
nature, and the sample size was relatively small. Therefore, bias may
have been introduced. However, we have routinely collected data on
postoperative functional outcomes in head and neck cancer for more than
15 years. Therefore, the reliability and consistency of our data may be
adequate. Second, in this study, most patients (87.8%) received
adjuvant radiation or chemoradiation therapy after TORS. Therefore, it
is a limitation to evaluate functional outcomes after TORS only,
excluding the effect of adjuvant treatment. Third, we did not compare
the functional results of TORS with those of conventional radical
surgery or concurrent chemoradiation therapy. Further comparative
studies with larger sample sizes and long-term follow-up are necessary
to more clearly determine postoperative long-term functional speech and
swallowing outcomes after TORS.