Authors : Zouloumis Lampros, Tilaveridis Ioannis, Lazaridis Nicolas and Koutsonikolas Dimitrios
Abstract: Oropharyngeal tumors are usually quamous cells carcinomas and rarely minor salivary tumors, lymphomas or lymphepitheliomas. Cancer of the posterior pharyngeal wall is relatively rare and needs a multidisciplinary approach. The treatment of oropharyngeal carcinoma remains controversial. Surgical treatments, radiotherapy, chemotherapy as well as a combination of these methods have been used. The extraoral approach with mandibular swing and the intraoral approach have been applied for resection of oropharyngeal cancers. The intraoral approach avoids the consequences of mandibular osteotomy and saves surgical time but it necessitate the, absolute control of intraoperative bleeding. In the study, reseachers present the case of a 40 years old woman with an exophytic squamous-cell carcinoma of the posterior pharyngeal wall. The tumor was staged as T2N0 according to clinical and imaging evaluation. The tumor was removed intraorally with the ligasure precise instrument, achieving an entirely bloodless operative field. A lyophilized dura was sutured to the defect of the posterior pharyngeal wall. Histopatologic evaluation showed verrucous carcinoma and the specimen was positive for Human Papilloma Virus (HPV 16). The patient received postoperative radiotherapy 5.500 cGy on the primary site and 5.000 cGy on the neck. Bone scanning with Tc-99 m, performed postoperatively was negative for metastasis. The postoperative course was uneventful and 19 months after surgery, the patient remains free of disease according to clinical and imaging evaluation without any impairment of the pharyngeal function.
Zouloumis Lampros, Tilaveridis Ioannis, Lazaridis Nicolas and Koutsonikolas Dimitrios, 2011. Bloodless Removal of a Primary Posterior Wall Oropharyngeal Carcinoma by Transoral Approach with the Ligasure Instrument, Case Report. Surgery Journal, 6: 13-17.