{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:08:18Z","timestamp":1747148898911,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Velopharyngeal insufficiency (VPI) is a known complication of transoral surgery (TOS) for oropharyngeal HPV\u2010mediated squamous cell carcinoma. Controversy exists regarding adequate resection margins for balancing functional and oncologic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study was exempted by the IRB. Patients who underwent TOS from January 2017 to October 2022 were included. Patient characteristics, treatment details, and oncologic and functional outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five patients were included. Mean and median follow\u2010up was 34\u2009months. 98% of patients were AJCC stage I\/II. Recurrence\u2010free survival was 96% with no local recurrences.<\/jats:p><jats:p>Univariate analysis demonstrated an association between VPI and pT stage (<jats:italic>p<\/jats:italic>\u2009=\u20090.035), medial pterygoid resection (<jats:italic>p<\/jats:italic>\u2009=\u20090.049), and palatal attachment sacrifice (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Multivariate analysis showed sacrifice of the palatal attachments remained a significant risk for VPI (<jats:italic>p<\/jats:italic>\u2009=\u20090.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Loss of soft palate pharyngeal attachments is an independent risk factor for VPI. When oncologically appropriate, the palatal attachments to the pharynx may be preserved.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27741","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T09:51:10Z","timestamp":1710928270000},"page":"1178-1188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of palatine tonsil tumor resection on postoperative velopharyngeal insufficiency in transoral surgery"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1859-0913","authenticated-orcid":false,"given":"Paul R.","family":"Wistermayer","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam E.","family":"Brown","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor B.","family":"Cave","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent A.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael L.","family":"Hinni","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard E.","family":"Hayden","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura E.","family":"Klusovsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa","family":"McGary","sequence":"additional","affiliation":[{"name":"Quantitative Health Science Research Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas H.","family":"Nagel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2021.3567"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00508\u2010017\u20101171\u20105"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104652"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010014\u20102985\u20107"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.12.1220"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2011.07.022"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200206000\u201000019"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2014.913809"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23353"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/17549507.2022.2104927"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2015.04.007"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2017.12.012"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010015\u20103526\u20108"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2014.10.004"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.2019"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010019\u201007645\u20109"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20269"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23900"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000508136"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14122990"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26693"},{"key":"e_1_2_10_23_1","unstructured":"National Comprehensive Cancer Network.Head and Neck Cancer (Version 1.2023). 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