Selective embolization of lingual artery in transoral robotic surgery for the management of recurrent base of tongue carcinomas. Issue 4 (24th December 2020)

• Record Type: Journal Article
• Authors: Rao, Vishal U. S.; Subash, Anand; R. Bhargavi, Vidya; Sinha, Piyush; Bagadia, Ritvi K.; Kudpaje, Akshay; Arakeri, Gururaj; Subbanna, Indusekhara
• Is Part Of: Head & neck. Volume 43:Issue 4(2021)
• Page Start: 1174
• Page End: 1183
• Publication Date: 2020-12-24
• Subjects: embolization -- hemorrhage -- oropharyngeal cancer -- robotic surgery; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26585
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: The incidence of oropharyngeal carcinoma has been on the rise in recent decades. About 30% of patients who undergo definitive chemoradiation as the initial treatment present with residual/recurrent disease. In such a situation, surgical salvage either in the form of traditional open surgery or transoral robotic surgery (TORS) remains a viable treatment option. However, the extensive vascular supply of the posterior tongue and tonsillar bed increases the risk of perioperative bleeding, which is a key concern. The article describes the technique of selective pre‐operative embolization to reduce the risk of perioperative bleeding and enumerate its advantages in providing a bloodless field during surgery. Methods: Prospective study of 5 patients with recurrent or residual midline BOT tumours who underwent TORS after selective lingual artery embolization at our centre. Results and Conclusions: None of the patients had any major perioperative bleeding or post procedural complications. All the patients after TORS had their tongue vascularity preserved with adequate recovery of tongue functions. Selective embolization of the feeder vessels provides a favorable bloodless surgical field without affecting the vascular integrity of the remnant tongue. This added advantage helps restoring the normal oral phase of swallowing.