Spotlight on Perfusion: Reshaping Oropharyngeal Squamous Cell Carcinoma Surgery

Oropharyngeal squamous cell carcinoma (OPSCC), commonly referred to as throat or tonsil cancer, is a type of head and neck malignancy arising from the base and posterior third of the tongue, tonsils, soft palate, and posterolateral pharyngeal walls. Standard treatment typically involves a single modality or a combination of surgery, radiotherapy, and/or chemotherapy. Despite favorable oncologic outcomes, chemoradiation is associated with considerable acute and long-term toxicities, including treatment-related mortality, debilitating dysphagia, fibrosis, severe xerostomia, and an increased risk of secondary malignancies. In this context, fluorescence-guided surgery (FGS) has emerged as a promising, minimally invasive intraoperative tool for OPSCC surgery. By leveraging indocyanine green (ICG), FGS offers enhanced visualization and real-time tissue differentiation, facilitating precise tumor resection and reducing the risk of surgical complications. This case presents an 83-year-old female patient who underwent radical OPSCC resection followed by complex reconstructive surgery utilizing a novel near-infrared FGS device.