Excision of a recurrent oropharyngeal malignant lesion utilizing a minimally invasive transoral robotic surgical (TORS) technique

EDUCATIONAL OBJECTIVE A comparison of open surgical techniques with minimally invasive techniques for the management of recurrent oropharyngeal lesions. OBJECTIVES The morbidity associated with open surgical approaches for the management of oropharyngeal lesions has led to minimally invasive techniques such as the transoral robotic surgery (TORS) in lieu of a mandibulotomy approach. There is a paucity of literature outlining its use for recurrent lesions. STUDY DESIGN Case report and literature review. METHODS A 78 year old male with multiple medical problems presented with a third recurrence of an oropharyngeal malignancy. The primary oropharyngeal malignancy was treated with radiation therapy. He subsequently underwent a partial glossectomy and pharyngectomy with free flap reconstruction for multiple recurrences. Finally, a TORS was performed for excision of a third recurrence. The operative course, length of hospital stay and postoperative follow-up was recorded. RESULTS The patient underwent a TORS excision of an oropharyngeal recurrence without complications. Frozen section histology demonstrated negative margins intraoperatively. An oral diet was commenced on hospital day 1 and he was discharged on hospital day 3. CONCLUSIONS The TORS technique has proven to be a minimally invasive surgical option for tumors of the oropharyngeal region. We present its use for the treatment of recurrent lesions with encouraging results.