Prospective instrumental evaluation of swallowing, tongue function, and QOL measures following transoral robotic surgery alone without adjuvant therapy.
BACKGROUND
Transoral robotic surgery (TORS) has been utilized to deintensify treatment. No studies have measured swallow safety and efficiency, nor assessed the functional impact of TORS alone.


METHODS
This prospective cohort underwent baseline and 1-month postsurgery assessments including modified barium swallow evaluation, using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) rating system, tongue range of motion assessment, the Performance Status Scale (PSS), and quality of life with the MD Anderson Dysphagia Inventory (MDADI).


RESULTS
All DIGEST safety scores were 0 (normal) at both time points. DIGEST efficiency scores were mildly impaired in 2 of 10 patients postsurgery. PSS scores revealed all patients were on regular diets, were 100% understandable, and were eating in public at both time points. Tongue Range of Motion scores were 100 of 100 at both time points. MDADI scores were not significantly different across time points.


CONCLUSIONS
Careful identification of patients can result in excellent outcomes following TORS. Future studies will examine longer follow-up of speech, swallowing, and tongue function in patients undergoing TORS surgery.
['Lazarus|Cathy L|CL|0000-0003-1046-4127', 'Ganz|Cindy|C|', 'Ru|Meng|M|', 'Miles|Brett A|BA|', 'Kotz|Tamar|T|', 'Chai|Raymond L|RL|']
D000328:Adult D000368:Aged D002294:Carcinoma, Squamous Cell D003679:Deglutition D005260:Female D005500:Follow-Up Studies D006258:Head and Neck Neoplasms D006801:Humans D008297:Male D008875:Middle Aged D011446:Prospective Studies D011788:Quality of Life D020127:Recovery of Function D065287:Robotic Surgical Procedures D013997:Time Factors D014059:Tongue D016896:Treatment Outcome
swallowing TORS DIGEST quality of life outcomes head and neck cancer