Robotic lateral oropharyngectomy following diagnostic tonsillectomy is oncologically safe in patients with high risk human papillomavirus related squamous cell cancer

Abstract

Purpose

Diagnostic tonsillectomy is rarely an oncologic operation owing to close or positive margins. The standard of care is for further treatment to the primary site, typically with adjuvant radiotherapy.

Methods

14 patients with close or positive margins following a diagnostic tonsillectomy underwent transoral robotic surgery (TORS) and lateral oropharyngectomy; five patients with the longest follow-up had their excision specimens examined with a step serial sectioning technique (SSS).

Results

Conventional histopathological examination of the TORS resection specimens did not demonstrate residual carcinoma in 13 patients, confirmed by examination using SSS in 5 patients. There were no post-operative complications or long-term functional deficit. Seven patients received surgery alone with 100% overall and disease specific survival, respectively (median follow-up 27.5 months; range 5.2–50.4).

Conclusions

This prospective study suggests that TORS lateral oropharyngectomy alone is an oncologically safe treatment when close or positive margins are identified on diagnostic tonsillectomy in HPV-positive SCC.

https://ift.tt/2rDPNx9

“White Thyroid” on Unenhanced Computed Tomography in Amiodarone-Induced Thyrotoxicosis Type 2

Thyroid, Ahead of Print.


https://ift.tt/2wB3tid

The Janus head of Bachelard’s phenomenotechnique: from purification to proliferation and back

Abstract

The work of Gaston Bachelard is known for two crucial concepts, that of the epistemological rupture and that of phenomenotechnique. A crucial question is, however, how these two concepts relate to one another. Are they in fact essentially connected or must they be seen as two separate elements of Bachelard's thinking? This paper aims to analyse the relation between these two Bachelardian moments and the significance of the concept of phenomenotechnique for today. This will be done by examining certain historical uses of the concepts of Bachelard have been used from the 1960s on. From this historical perspective, one gets the impression that these two concepts are relatively independent from each other. The Althusserian school has exclusively focused on the concept of 'epistemological break', while scholars from Science & Technology Studies (STS), such as Bruno Latour, seem to have only taken up the concept of phenomenotechnique. It in fact leads to two different models of how to think about science, namely the model of purification and the model of proliferation. The former starts from the idea that sciences are rational to the extent that they are purified and free from (epistemological) obstacles. Scientific objectivity, within this later model, is not achieved by eradicating all intermediaries, obstacles and distortions, but rather exactly by introducing as many relevant technical mediators as possible. Finally, such a strong distinction will be criticized and the argument will be made that both in Bachelard's and Latour's thought both concepts are combined. This leads to a janus-headed view on science, where both the element of purification (the epistemological break) and the element of proliferation (phenomenotechnique) are combined.

https://ift.tt/2IgdbYK

Prevalence of synchronous bilateral tonsil squamous cell carcinoma: A retrospective study

https://ift.tt/2IfE52E

Patient injuries in operative rhinology during a ten‐year period: Review of national patient insurance charts

https://ift.tt/2jRNoew

Current studies of immunotherapy in head and neck cancer

https://ift.tt/2IecjDL

Temporal patterns of patient‐reported trismus and associated mouth‐opening distances in radiotherapy for head and neck cancer: A prospective cohort study

https://ift.tt/2I9rja3