Description: This session will explore recent advancements in oral cavity surgery that balance oncologic control with preservation of function and quality of life. It will highlight innovative surgical approaches, including microvascular free flap reconstruction, and nerve-preserving techniques that minimize morbidity. Emerging trends such as the use of intraoperative imaging, navigation systems, and fluorescence-guided surgery for margin assessment will be discussed. Additionally, the session will examine the role of precision diagnostics and molecular profiling in surgical planning, along with multidisciplinary strategies to enhance functional outcomes in speech, swallowing, and aesthetics following resection.

Outcome Objectives:

1. Describe current surgical innovations in the treatment of oral cavity cancers, including TORS and advanced reconstructive techniques.
2. Evaluate the role of image-guided and fluorescence-assisted surgery in achieving clear margins.
3. Understand the impact of nerve preservation and reconstructive strategies on postoperative function and quality of life.
4. Integrate molecular and genomic data into surgical planning and risk stratification.
5. Apply multidisciplinary strategies to optimize oncologic and functional outcomes in oral cavity cancer care.

Background: Oral cavity cancers present a unique clinical challenge, where surgical treatment must achieve clear oncologic margins while preserving critical functions such as speech, swallowing, and appearance. Historically, extensive resections often led to significant morbidity. However, advances in surgical techniques, reconstruction, and perioperative care have markedly improved both survival and quality of life.

Technologies like transoral robotic surgery have enabled more precise resections in anatomically challenging regions, while microvascular free flaps and 3D planning have enhanced reconstructive outcomes. Intraoperative tools such as fluorescence-guided surgery and augmented imaging systems offer real-time assistance in assessing margins, reducing the risk of local recurrence. Moreover, molecular profiling is increasingly used to guide treatment selection and tailor follow-up.

This session is designed for head and neck surgeons, oncologists, and allied specialists committed to delivering high-quality, personalized care in oral cavity surgery. Through expert-led presentations and case-based discussions, attendees will gain practical knowledge to adopt these advances in their clinical practice.

Description: This presentation will explore the evolving role of partial laryngectomy in the treatment of T3 laryngeal cancer within the framework of contemporary organ preservation strategies. While concurrent chemoradiotherapy has become the preferred modality for many patients, particularly in an effort to preserve laryngeal function, surgical options such as partial laryngectomy remain highly relevant in selected cases. Through clinical evidence and case-based discussion, this session will highlight the indications, technical considerations, and outcomes of partial laryngectomy in the modern era.

Outcome Objectives: Understand the rationale behind organ preservation strategies in T3 laryngeal cancer and their current place in treatment guidelines. Identify the clinical and anatomical criteria that make a patient a candidate for partial laryngectomy. Compare the oncological and functional outcomes of partial laryngectomy versus non-surgical approaches such as chemoradiotherapy. Integrate multidisciplinary perspectives when evaluating treatment options for advanced laryngeal cancer.

Background: The management of T3 laryngeal cancer has significantly evolved over the past two decades, with a marked shift toward organ-preserving chemoradiotherapy protocols. While these approaches can successfully maintain the anatomical integrity of the larynx, they do not always guarantee preservation of its function and may be associated with long-term toxicity. In selected patients, partial laryngectomy offers an alternative that not only achieves local control but also provides favorable functional outcomes. However, the use of partial surgery has declined in clinical practice, often due to overgeneralization of non-surgical strategies. This presentation aims to revisit and recontextualize the role of partial laryngectomy in light of current evidence and patient-centered care considerations.

Background & Aim:

The pharyngocutaneous fistula (PCF) is the most common complication following a laryngectomy (LE) with a wide range of incidence and various potential risk factors. This study aimed to analyse the variability in the incidence and to identify the underlying causes for fluctuations in incidence rates.

Material & Methods:

In the retrospective study, the annual PCF incidence data and comprehensive clinicopathologic data from 540 patients who underwent TLE between January 2004 and December 2022 were reviewed. Distinct periods of both high and low PCF incidence were identified. Within these periods, patients were categorized into groups with PCF (study groups) and without it (control groups). These groups were statistically compared based on potential risk factors for PCF development. The high-incidence periods were specially analysed for recurring risk factors and the corresponding corrective measures were reviewed.

Results:

The analysis revealed four high-incidence periods with an overall PCF incidence of 37.61%, along with three low-incidence periods in between with an overall incidence of 19.38%. Surgical wound infection (SWI) and a history of head and neck cancer alongside their related treatments were repeatedly identified as independent risk factors during high-incidence periods, with SWI being the most consistent predictor of PCF development.

Conclusions:

Continuous monitoring of PCF incidence is crucial, as it allows for the identification of emerging risk factors and the immediate implementation of corrective measures to mitigate these newly identified risk factors.