Lateral Pharyngotomy for Selected Invasive Squamous Cell Carcinoma of the Lateral Oropharynx-Part I: How

Objectives/HypothesisTo revisit the surgical technique of lateral pharyngotomy in patients with selected, isolated, and untreated invasive squamous cell carcinoma of the lateral oropharynx. To describe postoperative management, complications, and functional outcomes. Study DesignRetrospective review from a French university teaching hospital. MethodsNinety-one patients consecutively underwent lateral pharyngotomy for selected T1-T4 squamous cell carcinoma of the lateral oropharynx. ResultsOf the patients, 73.6% and 98.9% experienced an uncomplicated surgical and medical postoperative course, respectively. There were no intraoperative deaths, but a single patient died in the immediate postoperative period from carotid rupture following salivary oropharyngeal fistula. The most common significant complications were severe postoperative swallowing impairment, pneumonia from aspiration, and salivary oropharyngeal fistula noted in 6.5%, 4.3%, and 4.3% of cases, respectively. In univariate analysis, none of the variables under analysis was related to the various significant complications noted and/or to immediate postoperative death. No patient had a permanent tracheotomy, whereas one had a permanent gastrostomy. Of the patients in whom a full course of radiation therapy was delivered postoperatively, 13.6% developed a major complication. ConclusionsFrom a functional point of view, lateral pharyngotomy is a safe, reliable surgery with few major complications and might be considered a valuable alternative to chemoradiation and/or mandibulotomy for selected tumors of the lateral oropharynx. Level of Evidence4 Laryngoscope, 123:2712-2717, 2013