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Laser tongue base mucosectomy is a useful diagnostic tool in the management of unknown primary cancers of the head and neck region

Published online by Cambridge University Press:  08 June 2022

O Olaleye Open the ORCID record for O Olaleye [Opens in a new window] ,
R Nassif ,
B Fleming  and
S Burrows
O Olaleye*
Affiliation:
ENT & Audiology, Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK
R Nassif
Affiliation:
ENT & Audiology, Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK
B Fleming
Affiliation:
Anaesthesia, Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK
S Burrows
Affiliation:
ENT & Audiology, Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK
*
Author for correspondence: Dr O Olaleye, ENT & Audiology, Norfolk & Norwich University Hospitals NHS Trust, Colney Lane, Norwich, NR4 7UY, UK E-mail: dejolaleye@yahoo.com Fax: +44 1603 287288
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Abstract

Objective

Tongue base mucosectomy identified cancer in 78 per cent of cancers of unknown primary in a recent meta-analysis. The carbon dioxide laser is an alternative technique if there is no access to a robot. This study aimed to describe the steps for undertaking tongue base mucosectomy using the carbon dioxide laser and its diagnostic utility in cancers of unknown primary.

Method

This was a prospective feasibility study utilising carbon dioxide laser for tongue base mucosectomy in cancers of unknown primary. Data collected included demographic data and p16 status.

Results

There were 14 cancers of unknown primary with 86 per cent p16 positivity on immunohistochemistry. Laser tongue base mucosectomy alone identified the cancer primary in 7 of 12 (58 per cent) cancers of unknown primary among p16 positive tumours and 0 of 2 (0 per cent) among p16 negative tumours. Combining bilateral tonsillectomy with laser tongue base mucosectomy resulted in identification of the primary cancer in 8 of 12 (67 per cent) p16 positive tumours.

Conclusion

In centres without a robot, tongue base mucosectomy using the carbon dioxide laser is a viable alternative, especially in combination with bilateral tonsillectomy in p16 positive cases.

Keywords

C02 LaserTongue BaseMucosectomyLingual TonsilUnknown PrimaryHead And Neck Cancer
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 4 , April 2023 , pp. 438 - 441
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr O Olaleye takes responsibility for the integrity of the content of the paper

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