Evidence map›Paper›PMID 25663269›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2015

Severe prolonged dysphagia following transoral resection of bilateral synchronous tonsillar carcinoma.

Alpen B Patel, Michael L Hinni, Taylor R Pollei, Richard E Hayden, Eric J Moore

Abstract readCase Reports
PubMed Publisher
In one paragraph

Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Incidence of synchronous contralateral tonsillar malignancy in a known case of unilateral tonsillar carcinoma.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022
    Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Alpen B PatelDepartment of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA. alpen@email.arizona.edu.
Michael L HinniDepartment of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA.
Taylor R PolleiDepartment of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA.
Richard E HaydenDepartment of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA.
Eric J MooreDepartment of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, USA.
Mayo Clinic in Arizona · USWinnMed · USMayo Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesAlert the reader to the complication of severe dysphagia following transoral laser microsurgery (TLM) or transoral robotic surgery (TORS) for bilateral simultaneous or synchronous tonsillar squamous cell carcinoma.

methodsA case series of four patients treated at an academic tertiary center between 2008 and 2012 is presented; two treated with transoral laser microsurgery and two with transoral robotic surgery for biopsy-proven untreated bilateral primary squamous cell carcinoma. Main outcome measures included functional swallowing determined by the Functional Outcome Swallowing Scale. The incidence of significant postoperative complications was recorded.

resultsTwo patients had surgery for discontiguous involvement of bilateral palatine tonsils with squamous cell carcinoma, while two patients had surgery for bilateral tonsillar squamous cell carcinoma with unilateral extension into the base of tongue. Complete swallowing failure as characterized by the Functional Outcome Swallowing Scale was seen postoperatively in 3/4 patients who underwent TLM or TORS for bilateral simultaneous tonsillar carcinoma, while one patient was lost to follow-up.

conclusionsSevere dysphagia in the setting of bilateral oropharyngectomy for simultaneous or synchronous tonsillar squamous cell carcinoma is rarely described but a significant concern. In an era with increased use of transoral surgery as de-escalation therapy, this unusual complication warrants consideration. We report that transoral bilateral pharyngectomy is quite harmful to near-term and intermediate-term swallowing outcomes. This paper serves to provide warning against primary surgical intervention in this setting, while demonstrating that non-surgical treatment may be the best viable option.

Indexed as

AgedBiopsyCarcinoma, Squamous CellDeglutition DisordersFemaleHumansLaser TherapyMaleMicrosurgeryMiddle AgedPalatine TonsilPharyngectomyRoboticsTongueTonsillar NeoplasmsTreatment OutcomeBilateralCarcinomaDysphagiaOropharynxSwallowingSynchronousTonsillarTransoral surgery

Identifiers

PMID25663269
OpenAlexW1986473241

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.