Transoral endoscopic ultrasonic surgery (TOUSS) in head & neck unknown primary carcinoma investigation

• Published in: Acta otorrinolaringológica española (English) 2023-05, Vol.74 (3), p.192-197
• Main Authors: Chiesa-Estomba, Carlos Miguel, Larruscain-Sarasola, Ekhiñe, González-García, Jose Ángel, Sistiaga-Suarez, Jon Alexander
• Format: Article
• Language: English
• Subjects: Amigdalectomía; Carcinoma; Cirugía; HPV; Humans; Natural Orifice Endoscopic Surgery - methods; Neoplasms, Unknown Primary - etiology; Neoplasms, Unknown Primary - pathology; Neoplasms, Unknown Primary - surgery; Pilot Projects; Primario desconocido; Robotic Surgical Procedures - methods; Surgery; Tonsillectomy; Transoral; Ultrasonic Surgical Procedures; Ultrasonics; Unknown primary; VPH
• ISSN: 2173-5735; 2173-5735
• DOI: 10.1016/j.otoeng.2022.10.001

Metastatic carcinoma of unknown primary (CUP) to cervical lymph nodes represents less than 5% of all head and neck malignancies. Recent publications support the use of transoral surgery during the diagnosis work-up, and transoral endoscopic ultrasonic surgery represent a recently described alternative technique in transoral surgery. A pilot study to assess the feasibility of trans-oral ultrasonic base of tongue (BOT) mucosectomy and bilateral tonsillectomy approach in CUP diagnosis work-up was conducted. Ten patients were included consecutively. In 2 cases (20%) the primary was found, in one case in the right tonsil, and another one in the left BOT. According to our results, the use of trans-oral ultrasonic surgery to perform the base of tongue mucosectomy and bilateral tonsillectomy in CUP patient’s during the diagnosis work-up represents an effective option in patients with good anatomical exposure. El carcinoma metastásico cervical de primario de origen desconocido (CPD) a las cadenas ganglionares linfáticas cervicales representa menos del 5% de todas las neoplasias malignas de cabeza y cuello. Publicaciones recientes avalan el uso de la cirugía transoral durante el proceso diagnóstico, a su vez la cirugía ultrasónica endoscópica transoral representa una alternativa técnica recientemente descrita. Se realizó un estudio piloto para evaluar la viabilidad de la mucosectomía transoral ultrasónica de la base de lengua (BDL) y la amigdalectomía bilateral en el diagnóstico de CPD. Se incluyeron 10 pacientes de forma consecutiva. En 2 casos (20%) se encontró el primario, uno en amígdala palatina derecha y otro en la BDL izquierda. De acuerdo con nuestros resultados, la cirugía ultrasónica transoral representa una técnica útil al momento de realizar una mucosectomía de la BDL, así como la amigdalectomía bilateral durante el proceso diagnóstico en pacientes con CPD.