swallowing function

A shifting paradigm for patients with head and neck cancer: transoral robotic surgery (TORS)

Source: www.cancernetwork.com Author: Amy Y. Chen, MD, MPH, FACS This paper by Drs. Bhayani, Holsinger, and Lai describes a new approach to an old problem. Advances in the management of head and neck cancer over the past few decades have been made predominantly in the area of non-surgical therapy. Starting with the Veterans Affairs Cooperative Trial for laryngeal cancer in the early 1990’s,[1] advances in the administration of chemotherapy and radiation therapy have enabled patients to forego traditional extensive resections that compromised speech and swallowing function.[2] The advances in combined chemoradiation for advanced head and neck cancer have come with a detriment to some patients in survival and quality of life.[3] Effective treatment, but with decreased morbidity was needed. Robotic surgery is one treatment that, in combination with chemotherapy and radiation, as needed, is yielding comparable oncologic outcomes while preserving speech and swallowing function. The authors detail the history of robotic surgery well. In short, the current daVinci system functions as a master-slave robot, with the surgeon manipulating instruments connected by a cable network to the robotic cart. Three arms exist (one for the camera and two accommodate 8mm and 5mm instruments). The camera enables not only magnification but also three dimensional viewing of the surgical field. The advantage of using robotic arms is the ability to reach locations that were previously not reachable without a mandibulotomy and/ or pharyngotomy. Stage III and IV cancers of the head and neck consist of primary tumors of all sizes. The major determinant [...]

Oral Cancer Foundation News Team - A2010-10-26T09:00:26-07:00October, 2010|Oral Cancer News|

Robotic surgery for oral cancer

Source: speech-language-pathology-audiology.advanceweb.com Author: Advance, Vol 20, Issue 2 A minimally invasive surgical approach to treat benign tumors and select malignant tumors in adults has been cleared by the U.S. Food and Drug Administration (FDA). The da Vinci Surgical System, developed by head and neck surgeons at the University of Pennsylvania School of Medicine, in Philadelphia, has been cleared for transoral otolaryngologic surgical procedures. Gregory Weinstein, MD, FACS, and Bert O'Malley, Jr., MD, founded the first TransOral Robotic Surgery (TORS) program in the world at Penn Medicine in 2004. They developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, larynx, tonsil, tongue, and other parts of the throat. Since 2005, approximately 350 patients at Penn have participated in the first prospective clinical trials of TORS. The trials compromise the largest and most comprehensive studies of the technology on record. "TORS has dramatically improved the way we treat head and neck cancer patients, completely removing tumors while preserving speech, swallowing, and other key quality-of-life issues," said Dr. O'Malley, chair of the Department of Otorhinolaryngology-Head and Neck Surgery at Penn Medicine. "It is very exciting that a concept conceived and tested at PENN and taught to surgeons and institutions within the U.S. and internationally has been officially recognized by our federal governing agencies and peers around the world as a new and improved therapy for select neck cancers and all benign tumors." As many as 45,000 Americans and approximately [...]

Oral Cancer Foundation News Team - A2010-05-09T10:23:23-07:00May, 2010|Oral Cancer News|

FDA clears transoral robotic surgery – developed at Penn –for tumors of mouth, throat and voice box

Source: www.healthcanal.com Author: staff A minimally invasive surgical approach developed by head and neck surgeons at the University of Pennsylvania School of Medicine has been cleared by the U.S. Food and Drug Administration (FDA). The da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, California) has been cleared for TransOral Otolaryngology surgical procedures to treat benign tumors and selected malignant tumors in adults. Drs. Gregory S. Weinstein and Bert W. O’Malley, Jr. of the University of Pennsylvania School of Medicine’s Department of Otorhinolaryngology: Head and Neck Surgery founded the world’s first TransOral Robotic Surgery (TORS) programat Penn Medicine in 2004, where they developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, voice box, tonsil, tongue and other parts of the throat. Since 2005, approximately 350 Penn patients have participated in the world’s first prospective clinical trials of TORS. These research trials compromise the largest and most comprehensive studies of the technology on record. “TORS has dramatically improved the way we treat head and neck cancer patients, completely removing tumors while preserving speech, swallowing, and other key quality of life issues,” said Bert O’Malley, Jr., MD, professor and chairman of Penn Medicine’s Department of Otorhinolaryngology:Head and Neck Surgery. “It is very exciting that a concept conceived at PENN, evaluated in pre-clinical experimental models at Penn, tested in clinical trials at Penn, and then taught to key surgeons and institutions both within the U.S. and internationally has been officially [...]

Oral Cancer Foundation News Team - A2009-12-19T23:10:00-07:00December, 2009|Oral Cancer News|

Aspiration, weight loss, and quality of life in head and neck cancer survivors

Source: Arch Otolaryngol Head Neck Surg. 2004;130:1100-1103 Authors: Bruce H. Campbell, MD et al. Objective: To determine associations between objective assessments (swallowing function and weight change) and subjective quality-of-life (QOL) measures. Design: Observational case series using clinical testing and questionnaires. Setting: University hospital-based tertiary clinical practice. Patients: Convenience sample of 5-year survivors of head and neck cancer (62 nonlaryngectomy survivors were studied). Interventions: Objective testing included examination, weight history, videofluoroscopic swallow studies (VFSS), and oropharyngeal swallowing efficiency (OPSE). Subjective testing included QOL questionnaires (University of Washington Quality-of-Life [UWQOL] Scale, Performance Status Scale for Head and Neck Cancer Patients [PSS-HN], Functional Assessment of Cancer Treatment–General [FACT-G] Scales, and Functional Assessment of Cancer Therapy–Head and Neck [FACT-H&N] Scale). Main Outcome Measures: Aspiration (identified by VFSS), weight change, and QOL measures. Results: Aspiration was associated with the decreased QOL scores in chewing, swallowing, normalcy of diet, and additional concerns of the FACT-H&N Scale. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales. Of the nonlaryngectomy survivors, 27 (44%) demonstrated some degree of aspiration during VFSS. Associations were found between aspiration, primary tumor T stage, weight change, and OPSE. Aspirators lost a mean of 10.0 kg from precancer treatment weight, while nonaspirators gained a mean of 2.3 kg (P

Oral Cancer Foundation News Team - A2009-05-20T09:37:36-07:00May, 2009|Oral Cancer News|