Table 2. Up-to-date Series of TORS for Upper Aerodigestive Tract Cancer with Assessment of Surgical Margins. Weinstein et al. found TORS may offer local control rates for oropharyngeal cancer similar to if not better than those seen with TLM, suggesting greater confidence in the surgical margin assessment seen with TORS en-bloc resection that lends itself to potentially more accurate pathologic evaluation.56 Inhibitors,research,lifescience,medical This result was not in concordance with Ansarin et al. who evaluated TORS versus TLM for resection of supraglottic cancer.57 Although en-bloc resection was reported to be easier with TORS, a higher proportion of positive resection margins

was found with TORS than with TLM, 40% and 20%, respectively. CONCLUSION Exposure, orientation, Inhibitors,research,lifescience,medical and co-operation with the pathologist are crucial principles needed to be followed in transoral surgery for success of margins assessment. Resection should be done with clear microscopic margins on pathologic report of 1–2 mm for glottic cancer and 2–5 mm for other non-glottic cancer. Piecemeal resection can be done, as needed, to better expose deep tumor involvement. Preservation of histological specimen orientation should be done by pinning the specimen on a corkboard with designation of

the adjacent tissue and inking surgical margins as needed. A schema including labels to the specimens and adjacent anatomic sub-sites can be very useful if expansion of margin is needed. Biopsies Inhibitors,research,lifescience,medical taken from surgical margins in critical sites surrounding site of resection, especially in deep borders, either for frozen section or final pathology, can lead to significant Inhibitors,research,lifescience,medical improvement of margin assessment. Although high rates of negative surgical margins can be achieved with TLM and TORS, decision-making on the need for adjuvant DAPT secretase purchase treatment should take into consideration not only the pathology report but also other important parameters during surgery such as the feasibility of

exposure and the surgeon’s judgment with regard to the completeness of excision. In order to have better evaluation and Inhibitors,research,lifescience,medical understanding of oncologic results it is necessary to form a consensus on how to assess and define surgical margins in transoral endoscopic surgery. Abbreviations: TLM transoral laser microsurgery TORS transoral robotic surgery.
The oropharynx is the posterior continuation aminophylline of the oral cavity. It is separated from the nasopharynx superiorly by the soft palate and the hypopharynx inferiorly by the base of the tongue at the level of the hyoid. Anteriorly, the junction of the hard and soft palates represents the border between the oral cavity and the oropharynx. Additional structures within the oropharynx include both lateral and posterior pharyngeal walls, soft palate, bilateral tonsillar regions, and base of tongue. Cancers of the tonsillar region and base of tongue make up the bulk of cases, whereas tumors of the pharyngeal walls and soft palate are much less common.