Only 3 of 18 required tracheostomy tube placement, and no patients required gastrostomy tube for enteral support.30 This suggests that, in a subset of non-smoking patients with HPV-related oropharyngeal cancer, excellent oncologic and functional outcomes are possible with TORS and neck dissection alone. More specific than HPV status, the latest studies looking into the prognosis of oropharyngeal carcinomas are examining the expression of the protein p16INK4a. The expression of p16INK4a is variable amongst oropharyngeal tumors, but has a strong selleck catalog association with HPV

positivity. In a study published within the last year, Quon et al. reported that p16INK4a Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical expression has not yet been associated with any significant difference in treatment outcomes, but limitations to this study leave room for further investigation.31

FUTURE DIRECTIONS Currently, transoral robotic surgery may still be considered to be in its infancy. Only 4 years have passed since FDA approval for its use in head and neck tumors. There are ongoing advances in robot technology, including those specific to head and neck surgery. New instruments are being developed that are smaller and better adapted for use in the oral cavity. In addition, more studies Inhibitors,research,lifescience,medical are being done on the indications for TORS as well as the different outcomes. Comparison studies of TORS versus other treatment modalities in the management of oropharyngeal cancers are still needed. Also, not enough time has passed for sufficient research into long-term outcomes of TORS thereby beyond 5 to 10 years. Inhibitors,research,lifescience,medical These are all areas of current ongoing research that have the potential greatly to affect the future direction of TORS. CONCLUSIONS

Transoral robotic surgery is a quickly developing Inhibitors,research,lifescience,medical technique in the management of oropharyngeal cancers. Studies of both tonsillar and tongue base tumors have shown favorable functional and oncologic outcomes after TORS. However, more research is still needed to evaluate long-term outcomes beyond 5–10 years. In the context of a growing proportion of HPV-related oropharyngeal cancers, TORS provides patients with a minimally invasive treatment option. Given the improved prognosis of this subset of oropharyngeal cancers, they Drug_discovery may be amenable to single modality treatment. TORS alone has shown promising results in treating HPV-positive tumors. There are no head-to-head studies comparing TORS alone to chemoradiation alone in the management of HPV-positive cancers, and this will likely be an area of future study. Abbreviations: FDA Food and Drug Administration HPV human papillomavirus PEG percutaneous endoscopic gastrostomy TORS transoral robotic surgery.
Use of endoscopic lasers was pioneered by Strong and Jako in the early 1970s.