Long-term functional swallowing and speech outcomes after transoral robotic surgery for oropharyngeal cancer

Objective: Transoral robotic surgery (TORS) for oropharyngeal cancer was introduced to ensure better functional preservation with less morbidity. However, long-term functional outcomes, especially speech and swallowing outcomes, have not been thoroughly investigated. This study aimed to evaluate the long-term functional swallowing and speech outcomes after transoral robotic surgery for oropharyngeal cancer. Methods We studied 41 patients with oropharyngeal squamous cell carcinoma who underwent TORS between January 2010 and December 2018. Tongue mobility, maximal phonation time, articulation, verbal diadochokinesis, reading speed, and modified barium swallowing tests were performed between two and three years after TORS to analyze the long-term functional speech and swallowing outcomes. Results: The mean patient age was 57.7 ± 9.9 years, and the male to female ratio was 34:7. The most common subsite was the palatine tonsil (73.2%), followed by the base of tongue (22.0%). Forty patients (97.6%) underwent concomitant neck dissection, and 36 patients (87.8%) received adjuvant radiation or chemoradiation therapy. Tongue mobility, maximum phonation time, articulation, verbal diadochokinesis, and reading speed were not different from those of the normal population. Modified barium swallowing outcomes were acceptable in most patients; however, one patient (2.4%) was dependent on a percutaneous endoscopic gastrostomy tube. None of the patients required a permanent tracheostomy. Conclusions: Long-term speech and swallowing functions after TORS were acceptable in most patients with oropharyngeal cancer. TORS is an excellent treatment modality for oropharyngeal cancer in terms of functional outcomes.