Transoral robotic surgery base of tongue mucosectomy for head and neck cancer of unknown primary

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Head and neck cancer of unknown primary (HNCUP) is a source of prognostic uncertainty for both patient and clinician. In general, 2–3% of all new cases of head and neck malignancy present as metastatic lymph node deposits where a primary tumour is unable to be identified on diagnostic evaluation.1 When a primary site is ultimately identified, the majority are of the tonsils (44.7%) and base of tongue (BOT, 43.9%).3 BOT represents a technically difficult anatomical site to assess through traditional means. Small tumours can easily go undetected on imaging and overlooked through tissue biopsy on panendoscopy.2 Transoral robotic surgery (TORS) has emerged as an expanding surgical technique for resecting tumours of the oropharynx.1 Its role in performing BOT mucosectomies for HNCUP can overcome the technical shortfalls of diagnosing BOT malignancies and provide a treatment adjunct with low complication rates.

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