Anatomical-based classification for transoral lateral oropharyngectomy

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Oncology

Background:

• Transoral lateral oropharyngectomy is a surgical technique used for oropharyngeal tumors.
• Standardized classification systems are needed to accurately define surgical extent and compare post-operative outcomes.
• Current classifications lack specificity, hindering consistent reporting.

Purpose of the Study:

• To propose a novel classification system for transoral lateral oropharyngectomy procedures.
• To establish clear definitions for different surgical approaches and their extensions.
• To improve the consistency and comparability of post-operative results in oropharyngeal surgery.

Main Methods:

• Development of a classification based on anatomical-surgical principles through author consensus.
• Categorization into three main types of lateral oropharyngectomy based on tissue resection depth and extent.
• Introduction of suffixes (A, B, C, D) to denote specific anatomical sites of resection.

Main Results:

• A three-tiered classification (Type 1, 2, 3) for transoral lateral oropharyngectomy is presented.
• Type 1 involves resection deep to pharyngobasilar fascia.
• Type 2 and 3 involve progressively wider resection of muscles and surrounding structures, including the parapharyngeal space in Type 3.
• Suffixes A, B, C, and D denote involvement of the soft palate, posterior pharyngeal wall, base of tongue, and retromolar trigone, respectively.

Conclusions:

• The proposed classification offers a simple and user-friendly system for categorizing transoral lateral oropharyngectomies.
• The classification facilitates precise description of resection extent using defined types and suffixes.
• This standardized approach is expected to enhance the definition and reporting of post-operative results in oropharyngeal surgery.