EBD is safe for both primary and post-surgical strictures. Stricture length and diameter of dilatation are predictive of success. In selected patients, treatment with EBD may reduce or delay the need for surgery.

ObjectiveThere has been little reported on the transoral reconstructive options following salvage transoral robotic surgery. This paper describes the facial artery musculomucosal flap as a method to introduce vascularised tissue to a previously irradiated resection bed.MethodsA facial artery musculomucosal flap was used to reconstruct the lateral pharyngeal wall in 13 patients undergoing salvage transoral robotic surgery for oropharyngeal squamous cell carcinoma. Outcomes recorded include flap and donor site complications, length of stay, and swallowing and speech outcomes.ResultsThere were no immediate or late flap complications, or cases of delayed wound healing in this series. There were two facial artery musculomucosal related complications requiring surgical management: one bleed from the facial artery musculomucosal donor site and one minor surgical revision. Healing of the flap onto the resection bed was successful in all cases.ConclusionThe facial artery musculomucosal flap provides a suitable transoral local flap option for selected patients undergoing salvage transoral robotic surgery for oropharyngeal malignancies.

No abstract

A 79-year-old man with a previous history of primary bilateral pulmonary adenocarcinomas was found to have a new parotid lesion on oncological surveillance imaging, raising the possibility of metastatic disease. Biopsy of the lesion confirmed metastatic deposit from primary lung adenocarcinoma. Following multidisciplinary discussions, the patient underwent a left parotidectomy where clear resection margins and preservation of facial nerve function were achieved.