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We investigated safety and efficacy of transoral robotic surgery (TORS) for base of tongue (BOT) reduction in obstructive sleep apnea syndrome (OSAS) patients. PubMed, Cochrane Library, and Scopus were searched. A meta‐analysis was performed. Random effects models were used. Thirty‐one cohorts met our criteria (1693 patients). The analysis was based mostly on retrospective studies. The summary estimate of the reduction of Apnea–Hypoxia Index (AHI) was 24.25 abnormal events per hour (95% CI: 21.69–26.81) and reduction of Epworth Sleepiness Scale (ESS) was 7.92 (95% CI: 6.50–9.34). The summary estimate of increase in lowest O2 saturation was 6.04% (95% CI: 3.05–9.03). The success rate of TORS BOT reduction, either alone or combined with other procedures, was 69% (95% CI: 64–79). The majority of studies reported low level of evidence but suggested that TORS BOT reduction may be a safe procedure associated with improvement of AHI, ESS, and lowest O2 saturation. [ABSTRACT FROM AUTHOR]

However, tracheotomy is associated with a prolonged hospitalisation time; yielding the TORS procedure less cost-effective.5 To date, there is no controlled study assessing the useful of tracheotomy in OSAS patients benefiting from TORS BOT reduction. Tracheotomy was performed in 10 patients (group 1), whereas 10 other patients did not have tracheotomy (group 2; randomisation process). Is tracheotomy necessary for transoral robotic surgery base of tongue reduction in obstructive sleep apnoea syndrome? Tracheotomy may impact both patient quality of life and self-image, which is another argument against doing prophylactic tracheotomy for benign conditions such as TORS BOT.10,11 The first weakness of this preliminary study is the low number of patients. [Extracted from the article]

Background: We investigated the survival of patients with a p16‐positive N3 oropharyngeal squamous cell carcinoma (OPSCC) and the prognostic significance of patient, tumor, and treatment characteristics. Methods: We retrospectively reviewed the data of patients treated at our Cancer Center for a p16‐positive N3 OPSCC between 2003 and 2016. End points were overall survival (OS) and progression‐free survival (PFS). Results: A total of 29 patients were included. The 5‐year OS and PFS were 67.5% and 59.1%, respectively. Smoking history above 10 pack‐years and the absence of human papillomavirus DNA were associated with worse OS (P = .02 and P = .03, respectively) and PFS (P = .02 and P = .02, respectively). Induction chemotherapy or radical neck dissection were not associated with different treatment outcomes. Conclusion: Patients with an N3 p16‐positive oropharyngeal cancer in our series had a 5‐year OS rate of 67.5%. Smoking history and viral DNA were prognostic factors associated with survival. [ABSTRACT FROM AUTHOR]