First transoral robotic lateral oropharyngectomy in Oregon outside of Portland
Subject: A 54-year-old man was referred to PeaceHealth Medical Group otolaryngologist Abraham Sorom, MD, for a right-side neck mass that had been present for several weeks. The mass was both visible and palpable. In recent days, the patient had developed a slight sore throat, but had no other symptoms.
Diagnosis: Neck mass is the most frequent indicator of throat cancer; such masses are often discovered incidentally during a physical examination. All firm, hard masses in the throat/neck area are treated as cancer until proven otherwise. During a physical examination of the patient, Dr. Sorom identified a 4.5 cm neck mass. An initial workup including CT scan and needle biopsy identified stage 3 metastatic squamous cell carcinoma of the tonsillar region (95 percent of head and neck cancer is of this kind).
Treatment: Dr. Sorom biopsied the tonsil area and located the primary tumor. On Nov. 4, 2010, he used the da Vinci Si Surgical System at Sacred Heart Medical Center at RiverBend to perform the first transoral robotic lateral oropharyngectomy in Oregon outside of Portland. The patient was discharged from the hospital the next morning. Two weeks later, Dr. Sorom removed the neck mass and surrounding lymph nodes in a delayed neck dissection.
Outcome: The patient is eating and swallowing normally. His case is being monitored and may require follow-up radiation therapy. Without TORS, treatment options would have been chemotherapy and radiation therapy, which have serious side effects. TORS obviates the need for disfiguring mandibulotomy, which is sometimes required when the tumor site cannot be accessed through the mouth. The da Vinci system provides binocular vision with depth perception, which often enables surgeons to resect less tissue and make more precise incisions. About one in 15 throat cancer patients are candidates for the procedure. “Whenever a patient presents with an appropriate tumor, size and location, we will perform the robotic procedure,” Dr. Sorom said.