Characterizing postoperative physiologic swallow function following transoral robotic surgery for early stage tonsil, base of tongue, and unknown primary human papillomavirus-associated squamous cell carcinoma.

Journal Article (Journal Article)

BACKGROUND: Data objectively evaluating acute post-transoral robotic surgery (TORS) swallow function are limited. Our goal was to characterize and identify clinical variables that may impact swallow function components 3 weeks post-TORS. METHODS: Retrospective cohort study. Pre/postoperative use of the Modified Barium Swallow Impairment Profile (MBSImP) and Penetration-Aspiration Scale (PAS) was completed on 125 of 139 TORS patients (2016-2019) with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma. Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scores were retrospectively calculated. Uni/multivariate analysis was performed. RESULTS: Dysfunctional pre-TORS DIGEST scores were predictive of post-TORS dysphagia (p = 0.015). Pre-TORS MBSImP deficits in pharyngeal stripping wave, swallow initiation, and clearing pharyngeal residue correlated with airway invasion post-TORS based on PAS scores (p = 0.012, 0.027, 0.048, respectively). Multivariate analysis of DIGEST safety scores declined with older age (p = 0.044). Odds ratios (ORs) for objective swallow function components after TORS were better for unknown primary and tonsil primaries compared to base of tongue (BOT) (OR 0.35-0.91). CONCLUSIONS: Preoperative impairments in specific MBSImP components, older patients, and BOT primaries may predict more extensive recovery in swallow function after TORS.

Full Text

Duke Authors

Cited Authors

  • Ottenstein, L; Cornett, H; Switchenko, JM; Nathan, M; Thomas, S; Gillespie, AI; McColloch, N; Barrett, T; Studer, MB; Brinkman, M; Kaka, AS; Boyce, BJ; Ferris, RL; Aiken, AH; El-Deiry, M; Beitler, JJ; Patel, MR

Published Date

  • May 1, 2021

Published In

Volume / Issue

  • 43 / 5

Start / End Page

  • 1629 - 1640

PubMed ID

  • 33547716

Pubmed Central ID

  • PMC8046724

Electronic International Standard Serial Number (EISSN)

  • 1097-0347

Digital Object Identifier (DOI)

  • 10.1002/hed.26632


  • eng

Conference Location

  • United States