Reconstructive Ladder for Transoral Resections of Oropharyngeal Cancers

Abstract

Purpose of Review

Transoral robotic surgery (TORS) now offers extended reach and capability to the head and neck oncologic surgeon, but in doing so, provides a reconstructive dilemma. The objective of this manuscript is to discuss the most recent advances and options available after resection with TORS.

Recent Findings

The latest research provides a common framework for surgeons to classify the type of oropharyngeal defect. A variety of reconstructive options described include secondary intent, modifications to existing local and regional flaps, and advances utilizing robotic assistance in free flap reconstruction.

Summary

There exists a multitude of reconstructive options with appropriate considerations for a stepwise approach based on patient-specific factors, surgeon capability, and the extent of the oropharyngeal defect. Just as robotic resection extends the capability in extirpation, it is now being used to refine free flap inset in the appropriate case.

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