The Role of Transoral Robotic Surgery, Transoral Laser Microsurgery, and Lingual Tonsillectomy in the Identification of Head and Neck Squamous Cell Carcinoma of Unknown Primary Origin: a Systematic Review

Overview

Journal J Otolaryngol Head Neck Surg

Publisher Sage Publications

Specialties General Surgery
Otorhinolaryngology

Date 2016 May 5

PMID 27142355

Citations 23

Authors

Terence S Fu

Andrew Foreman

David P Goldstein

John R de Almeida

Affiliations

Soon will be listed here.

Abstract

Background: Squamous cell carcinoma of the head and neck can present as a cervical metastasis from an unknown primary site. Recently, transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) have been incorporated in the workup of unknown primary tumors.

Methods: We searched MEDLINE, EMBASE, Cochrane, and CINAHL from inception to June 2015 for all English-language studies that utilized TORS, TLM, or lingual tonsillectomy in the approach to an unknown primary.

Results: Of 217 identified studies, eight were reviewed. TORS/TLM identified the primary tumor in 111/139 (80 %) patients overall, and 36/54 (67 %) patients with no remarkable findings following physical exam, radiologic imaging, and panendoscopy with directed biopsies. Lingual tonsillectomy identified the primary tumor in 18/25 (72 %) patients with no findings. Hemorrhage (5 %) was the most common perioperative complication.

Conclusion: Lingual tonsillectomy using new approaches such as TORS/TLM may improve the identification of occult primary tumors.

Citing Articles

The Effectiveness of Tonsillectomy in the Diagnostic Workup of Squamous Cell Carcinoma Unknown Primary in the Head and Neck Based on p16 Immunohistochemistry.

Stefanicka P, Krupkova K, Pavlovcinova G Medicina (Kaunas). 2025; 60(12.

PMID: 39768814 PMC: 11678488. DOI: 10.3390/medicina60121932.

Predictors for Success and Failure in Transoral Robotic Surgery-A Retrospective Study in the North of the Netherlands.

Toppenberg A, Nijboer T, van der Laan W, Wedman J, Schwandt L, Plaat R Cancers (Basel). 2024; 16(8).

PMID: 38672541 PMC: 11048242. DOI: 10.3390/cancers16081458.

The Role of Trans Oral Robotic Surgery in the Carcinoma of Unknown Primary: A New Evidence in the Horizon?.

Chettuvatti K, Panda N, Bakshi J, Verma R, Nayak G, Goel N Indian J Otolaryngol Head Neck Surg. 2024; 76(2):1941-1948.

PMID: 38566719 PMC: 10982237. DOI: 10.1007/s12070-023-04460-3.

Head and Neck Squamous Cell Carcinoma of Unknown Primary: A Diagnostic Work-Up.

Manoharan M, Kalman N, Rabinowits G Oncologist. 2023; 29(3):192-199.

PMID: 37995312 PMC: 10911926. DOI: 10.1093/oncolo/oyad311.

Head and neck squamous cell carcinoma with heterotopic ossification, lymphovascular invasion, and nodal and pulmonary metastases in a 23-year-old Morgan gelding.

Townsend K, Johnson P, Kuroki K Can Vet J. 2023; 64(7):627-632.

PMID: 37397690 PMC: 10286139.

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