Browsing by Author "Koch, Wayne"

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    Transoral Lateral Oropharyngectomy/Radical Tonsillectomy for Cancer of the Tonsil: Anatomy, Principles and Techniques
    (University of Cape Town, 2025-05-19) Fagan, Johan; Koch, Wayne; Fagan, Johan
    In high income countries, early (T1/2) tonsil cancers are commonly resected by lateral oropharyngectomy (radical tonsillectomy) employing transoral CO2 laser microsurgery or transoral robotic surgery (TORS) techniques. Yet most surgeons in the world do not have access to CO2 laser or TORS. In such centers early tonsil cancers are often resected by simple tonsillectomy. However, dissecting along the tonsillar capsule and not including the pharyngeal constrictors as the deep margin often results in close or involved deep margins necessitating adjuvant (chemo)radiation. Because cancers of the tonsil are in a direct line-of-sight for the surgeon when using a simple tonsillectomy gag, there is little reason why the surgical principles that apply to lateral oropharyngectomy by transoral CO2 laser or TORS techniques should not be employed to lateral oropharyngectomy performed with headlight/diathermy, or microscope/diathermy, or loupes/head-light/diathermy techniques to secure adequate resection margins.