Background:
Transoral Robotic Surgery (TORS) is a minimally invasive approach for the treatment of oropharyngeal squamous cell carcinoma (OPC). The effects on swallowing and speech need to be comprehensive evaluated in order to understand the associated morbidity and to educate prospective patients pre- and post-operatively.
Methods:
A prospective cohort of 21 patients were recruited to undergo baseline and repeated post-operative swallowing, communication and weight measurements up to x months post-surgery. Fibreoptic endoscopic evaluation of swallowing was used to examine secretion burden, airway protection, aspiration risk and the presence of residue.
Results:
16 patients (76.2%) had penetration-aspiration scores ≥ 3 or higher, seven (33.3%) aspirated on liquids and three (14.3%) did so silently, representing a deterioration in swallow function compared with baseline, with a recovery trajectory that did not return to baseline for 9 (42.5%) patients at 6 months. Swallowing and communication scores were significantly worse in base of tongue primary tumours and with advanced age.
Conclusion:
Patients experience a significant decline in swallowing function post-TORS with a heavy secretion load, pharyngeal residue, laryngeal penetration and aspiration, and weight loss. This improves within 3 months but often does not reach baseline levels in this period. Silent aspiration occurred in 14% and thus warrants instrumental assessment to ascertain aspiration risk.