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Objective: Surgeons generally determine depth of resection during transoral laser cordectomy by visual inspection of the surgical field. Our aim was to examine the correlation between early glottic cancer depth of resection as reported by surgeons in the operation report and depth of resection defined by pathology specimens, using various staining techniques intended to differentiate between the distinct vocal fold layers based on particular collagen deposition. Study Design: Retrospective study. Setting: A voice and swallowing clinic at a tertiary referral hospital. Methods: We compared depth of cordectomy assessed intraoperatively by surgeons and by pathologists using Picrosirius red stain and collagen I immunohistochemistry stain in 32 patients who underwent transoral laser cordectomy for early glottic cancer. Results: For type I, II, and III cordectomy, the respective proportions of patients were 14 (47%), 9 (30%), and 7 (23%) according to surgeons' estimations; 2 (6%), 17 (55%), and 12 (39%) according to Picrosirius red stain; and 3 (11%), 12 (44%), and 12 (45%) according to immunohistochemistry for collagen I. Conclusion: Surgeons' reported depth of resection did not correlate with depth of resection established by either staining technique. Determining depth of resection necessitates special stains, which should help in the clinical assessment of cordectomy type. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: This study aimed to evaluate the long-term swallowing performance following transoral robotic surgery (TORS) to the base of tongue (BOT) in the treatment of obstructive sleep apnea (OSA).Study Design: Retrospective and prospective cohort study.Methods: Data analysis of 39 patients who underwent BOT reduction via TORS to treat OSA at our center from September 2013 to April 2016. Long-term swallowing functions were assessed using subjective self-evaluated swallowing disturbances questionnaire (SDQ) and objective fiberoptic endoscopic evaluation of swallowing (FEES).Results: Seven patients underwent TORS BOT reduction alone, whereas 32 had also uvulopalatoplasty ± tonsillectomy, with a surgical success rate of 71.4%. Mean time for swallowing evaluation was 27.4 ± 9.43 months. Twenty-five patients completed the SDQ with an average score of 9.26 ± 10.05. In 32%, the SDQ was positive for dysphagia. In 10 out of 14 patients who underwent FEES, swallowing problems were noticed. The most common pathological findings were food residue in the vallecula followed by early spillage of food into the hypopharynx, penetration of solid food and liquid on the vocal folds surface, and aspiration.Conclusions: BOT reduction via TORS has a negative effect on long-term swallowing function. A self-assessment questionnaire can help detect patients who suffer from swallowing impairment. Postoperative objective swallowing tests are essential not only in the immediate postoperative period but also during late routine follow-up. Proper patient selection and detailed information about surgery and possible late-swallowing effect are important factors before scheduling BOT reduction via TORS for OSA treatment.Level Of Evidence: 4 Laryngoscope, 129:422-428, 2019. [ABSTRACT FROM AUTHOR]