Sagittal mandibulectomy provided safe oncologic margins and functional and esthetic advantages in the surgical treatment of tonsillar cancers that abut but do not infiltrate the mandible.
Mandible ; Tonsillar Neoplasms*

Four consecutive patients underwent composite resection of tonsillar cancer and reconstruction with a microvascular radial forearm free flap. Three patients had postoperative assessments of speech at six to nine months respectively. One patient could not attend for the postoperative assessment. The speech assessment was examined by same speech therapist. All the patients had an good postoperative speech assessment. Compared to conventional local or regional myocutaneous flaps, the thin forearm free flaps offers better postoperative articulatory recovery.
Forearm* ; Free Tissue Flaps* ; Humans ; Myocutaneous Flap ; Tonsillar Neoplasms

Transoral robotic system (TORS) is performed by positioning at least 3 robotic arms through the oral cavity that are operated by the surgeon bimanually. The elaborate movements of the operating tools and high resolution endoscopic images provided by the robot can overcome the shortcomings of transoral radical lateral oropharyngectomy, thus enabling wide and effective surgery. Also, it preserves postoperative functions and improves the quality of life, thereby decreasing postoperative morbidity. In this study, the possibility of TORS as a novel surgical method in managing tonsillar carcinoma has been identified. However, a long term observation regardingpostoperative swallowing, phonation, quality of life and oncologic safety in using TORS is further required.
Arm ; Deglutition ; Mouth ; Phonation ; Quality of Life ; Tonsillar Neoplasms

Female ; Humans ; Middle Aged ; Sarcoma, Myeloid ; Tonsillar Neoplasms

Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Palpation ; Tonsillar Neoplasms ; diagnosis ; secondary

Acupuncture Therapy ; Aged ; Female ; Humans ; Radiotherapy ; adverse effects ; Tonsillar Neoplasms ; radiotherapy ; Xerostomia ; etiology ; therapy

Adult ; Airway Obstruction ; etiology ; Anesthetics ; adverse effects ; Humans ; Male ; Polyps ; complications ; Tonsillar Neoplasms ; complications ; Young Adult

Epiglottis ; pathology ; Humans ; Palatine Tonsil ; Tissue Adhesions ; diagnosis ; Tonsillar Neoplasms ; radiotherapy

BACKGROUND: The soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate. METHODS: Six patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools: nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation. RESULTS: Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%). The mean score of the speech acuity test was 5.84 (range, 5 to 6). These mean ratings represent a satisfactory level of speech function. CONCLUSIONS: The large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.
Forearm ; Free Tissue Flaps ; Humans ; Palate, Soft ; Prognosis ; Tendons ; Tonsillar Neoplasms

PURPOSE: We wanted to present the preliminary results of intensity-modulated radiotherapy (IMRT) for the treatment of tonsillar cancer. MATERIALS AND METHODS: We retrospectively analyzed 12 patients who underwent IMRT for tonsillar cancer at Asan Medical Center between November 2002 and February 2007. Seven patients (58%) received definitive treatment, and five (42%) were treated in the postoperative setting. Among the definitively treated patients, 6 patients received cisplatin-based chemotherapy regimens. Simultaneous modulated accelerated radiation therapy (SMART) was used in nine patients. The prescribed dose was 72 Gy at 2.4 Gy/fraction for the definitively treated cases and 61.6 Gy at 2.2 Gy/fraction for the postoperative cases. The median follow-up period was 34 months. RESULTS: All twelve patients completed treatment without interruption, and eleven showed a complete response. One patient had persistent loco-regional disease after treatment. The three-year estimates of loco-regional control, disease-free survival and overall survival were 91.7%, 91.7%, and 100%. The worst acute mucositis was Grade 1 in four patients, Grade 2 in five patients, Grade 3 in two patients and Grade 4 in one patient. Grade 3 xerostomia was observed in six patients. CONCLUSION: Intensity-modulated radiotherapy was shown to be a safe and effective treatment modality for tonsillar cancer. Further studies with a larger number of patients and a longer follow-up period are needed to evaluate the ultimate tumor control and late toxicity of IMRT for treating tonsillar cancer.
Disease-Free Survival ; Follow-Up Studies ; Humans ; Mucositis ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Tonsillar Neoplasms ; Xerostomia