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Management of the Neck for Oropharyngeal Squamous Cell Carcinoma in the Era of Transoral Robotic-Assisted Surgery (TORS)

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Atlas of Head and Neck Robotic Surgery

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Abstract

In recent years, transoral robotic-assisted surgery (TORS) has revolutionized the surgical management of malignant tumors of the oropharynx that were once only accessible through open procedures such as mandibulotomy and pharyngotomy. TORS has facilitated the de-escalation of chemoradiation therapy in select patients, sparing them the morbidity of these therapies while not compromising oncologic outcome. However, the oncologic efficacy of TORS also relies on the appropriate management of the neck as this greatly influences locoregional and distant recurrence, as well as overall survival. Therefore, neck dissection is an important component of any TORS procedure performed for malignancy. This chapter will discuss the basic elements related to neck dissection for squamous cell carcinoma for oropharyngeal primary tumors resected by TORS and current controversies surrounding neck dissection such as the impact of HPV status on the behavior of nodal metastases. Additionally, relevant complications of neck dissection and preventative measures during neck dissection (i.e., prophylactic transcervical arterial ligation) to reduce the severity of complications of TORS will also be discussed.

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Author information

Authors and Affiliations

  1. Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10021, USA

    Rajarsi Mandal MD, Ian Ganly MD, PhD & Snehal G. Patel MD, FRCS (Glasg)

  2. Weill Medical College of Cornell University, New York, NY, USA

    Snehal G. Patel MD, FRCS (Glasg)

Authors
  1. Rajarsi Mandal MD
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  2. Ian Ganly MD, PhD
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  3. Snehal G. Patel MD, FRCS (Glasg)
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Corresponding author

Correspondence to Snehal G. Patel MD, FRCS (Glasg) .

Editor information

Editors and Affiliations

  1. Israel Institute of Technology, The Head and Neck Center, Rambam Healthcare Campus, Haifa, Israel

    Ziv Gil

  2. Israel Institute of Technology, The Head and Neck Center, Rambam Healthcare Campus, Haifa, Israel

    Moran Amit

  3. Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA

    Michael E. Kupferman

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Mandal, R., Ganly, I., Patel, S.G. (2017). Management of the Neck for Oropharyngeal Squamous Cell Carcinoma in the Era of Transoral Robotic-Assisted Surgery (TORS). In: Gil, Z., Amit, M., Kupferman, M. (eds) Atlas of Head and Neck Robotic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-49578-1_21

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  • DOI: https://doi.org/10.1007/978-3-319-49578-1_21

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