Outcomes
The mean duration of surgery was longer for lateral than for medial approaches (P = .02) (Table 1). Post-surgical complications were more frequent with lateral approaches (P = .01), with the highest rate (72%) associated with the transcervical-transparotid approach, due to postoperative facial palsy. The only complications associated with TORS were one case of cervical hematoma and one of pharyngeal wound dehiscence with temporary velopharyngeal incompetence (Tables 1 and 2). The free margin rate was 75% for both approaches.
Four patients in each group required a feeding tube. The mean time in those treated with a lateral approach was 2.6 days, while the two undergoing transcervical-transmandibular surgery required a tube for a mean of 13 days. The mean time in those treated with a medial approach was 1.9 days, while the patient undergoing TORS + transcervical required a tube for five days.
The mean length of hospital stay overall was similar with both approaches (P = .19) (Table 1). Among patients treated with a medial approach, hospital stay was longer in those with post-surgical complications than in those without (12 vs 4.75 days; P = .01). With a lateral approach, length of hospital stay was similar for those with and without complications (9 vs 8.6 days; P = .93).
With a median follow-up of 32 months (range, 4-60), there were no significant differences in 2-year relapse-free survival rates between the two groups (Table 1).