{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:01:31Z","timestamp":1787504491808,"version":"build-2736575974"},"reference-count":51,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Approximately 10% of recurrent oropharyngeal squamous cell carcinoma (OPSCC) cases undergoing salvage surgery require reconstruction. Treatment options include transoral robotic surgery (TORS) combined with microvascular free or pedicled flaps including the submental island flap (SMIF). This study evaluates perioperative, oncological, and functional outcomes of patients with recurrent OPSCC treated with TORS and SMIF reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study included patients treated between 2019 and 2024. Perioperative, oncologic, and functional data were collected. Swallowing was evaluated with a video swallow study graded with the Dynamic Image Grade of Swallowing Toxicity (DIGEST) scoring system. A DIGEST-score increase of 2\u2009points or more compared to baseline was considered a significant decrease in swallowing function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eight patients were included. The mean time between initial OPSCC and recurrence was 4.7\u2009years (SD\u2009=\u20093.1). Average operative time was 314\u2009minutes (SD\u2009=\u200931.6). Three patients (37.5%) received a tracheostomy for 5\u2009days. The median length of stay was 6.5\u2009days (IQR\u2009=\u20096-7). Postoperative complications occurred in 2 patients (25%). Three patients (37.5%) underwent adjuvant therapy. During a follow-up time of 23.7\u2009months (IQR\u2009=\u200919.1) 1 patient died due to disease. Patients required enteral feeding for a median of 43\u2009days (IQR\u2009=\u200915-197). DIGEST-scores showed no significant change in swallowing at 6\u2009weeks and 6\u2009months compared to baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The SMIF is a reliable reconstructive option for salvage TORS-patients. It is readily available without microvascular expertise, provides healthy vascularized tissue that is outside the at-risk nodal basin, and results in excellent functional outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894251347103","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T09:26:04Z","timestamp":1750411564000},"page":"797-805","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Salvage Transoral Robotic Surgery With Submental Flap Reconstruction: Functional and Oncologic Outcomes"],"prefix":"10.1177","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8938-5805","authenticated-orcid":false,"given":"Emilie C. M.","family":"de Groot","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts Eye and Ear\/Mass General Brigham, Boston, MA, USA"},{"name":"Department of Otolaryngology, Amsterdam Universitair Medisch Centrum (AUMC), Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C.","family":"Nyirjesy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts Eye and Ear\/Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L.","family":"Faden","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts Eye and Ear\/Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick T.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts Eye and Ear\/Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"Deschler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts Eye and Ear\/Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen L.","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts Eye and Ear\/Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy D.","family":"Richmon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts Eye and Ear\/Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20998"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.6987"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-022-00603-7"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29659"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20647"},{"key":"e_1_3_3_7_2","unstructured":"National Cancer Institute. Oropharyngeal Cancer Treatment (PDQ\u00ae)\u2013Health Professional Version. 2024. Accessed June 8 2025. https:\/\/www.cancer.gov\/types\/head-and-neck\/hp\/adult\/oropharyngeal-treatment-pdq"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.1937"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29323"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24595"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.01.004"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1368-8375(03)00150-7"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.3866"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2023.106467"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2017.01.003"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197508000-00011"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.08.029"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-023-01572-4"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2012.03.004"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2017.08.003"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815607345"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215119000744"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199392050-00013"},{"issue":"6","key":"e_1_3_3_24_2","first-page":"380","article-title":"Cost analysis in oral cavity and oropharyngeal reconstructions with microvascular and pedicled flaps","volume":"33","author":"Deganello A","year":"2013","unstructured":"Deganello A, Gitti G, Parrinello G, Muratori E, Larotonda G, Gallo O. Cost analysis in oral cavity and oropharyngeal reconstructions with microvascular and pedicled flaps. Acta Otorhinolaryngol Ital. 2013;33(6):380-387.","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26543"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0528"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.12.1220"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.250"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419862582"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30283"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-016-9758-y"},{"key":"e_1_3_3_32_2","unstructured":"American Cancer Society. Treatment Options for Oral Cavity Cancer by Stage-Recurrent oral cavity cancer. 2021. Accessed December 9 2024. https:\/\/www.cancer.org\/cancer\/types\/oral-cavity-and-oropharyngeal-cancer\/treating\/by-stage.html"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3857\/roj.2020.00213"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814542939"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2019.09.185"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819830664"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/0145561320937627"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001263"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2017.08.007"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.09.024"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20743"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.410"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28429"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2018.11.008"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1177\/0003489416672871"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000715"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.053"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1759795"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1709115"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.741"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.0691"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2024.107050"}],"container-title":["Annals of Otology, Rhinology &amp; Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894251347103","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00034894251347103","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894251347103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:31:18Z","timestamp":1777375878000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00034894251347103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,20]]},"references-count":51,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/00034894251347103"],"URL":"https:\/\/doi.org\/10.1177\/00034894251347103","relation":{},"ISSN":["0003-4894","1943-572X"],"issn-type":[{"value":"0003-4894","type":"print"},{"value":"1943-572X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,20]]}}}