Ligation of carotid artery branches during TORS tonsillectomy and base of tongue disection

jkinobay Member Posts: 265 Member
edited May 14 in Head and Neck Cancer #1

I am being scheduled for a TORS procedure relative to the base of what used to be my right tonsil. A recent biopsy found Squamous Cell Carcinoma, HPV16 Positive. PET and CT scans indicate no metastisis. Oncologist rated T-1 M-0 N-O

This is my second tonsilar cancer. My left tonsil was found to be malignant back in 2007. Lymphonodectomy, followed by tonsillectomy, followed by weekly Cisplatin and 35 IMRT did the trick and I had been NED for almost 15 years until this new cancer appeared on the opposite side.

TORS surgeon is recommending removing the tumor with margins, probably small disection of base of tongue, and neck dissection to check lymph nodes. He also says it would be advantageous to perform a ligation of some of the branches of the carotid artery.

I know absolutely nothing about that. I would appreciate comments from those of you who may have already experienced these procedures. I am 72 and otherwise in good health. My major holdback is having had all the radiation, chemo and limited surgery back in 2007.

So, please tell me about recovery from the carotid ligation, the neck dissection and the TORS tonsillectomy with partial disecction of base of tongue.

Thank you so much for whatever you can share. The procedure is scheduling toward the end of May so I would like to know as much as possible in advance.

Coincidentally, I have a half-brother, same mother (who died of uterine cancer in 1958) who is just finishing surgery and radiation for the identical SCC, HPV 16 Positive, left tonsil. M.D. Anderson is convinced we both contracted the HPV from her during the trip through the birth canal.

Jim K


  • wbcgaruss
    wbcgaruss Member Posts: 1,320 Member

    Well, Jim, I am not an expert on anything but I think your case may be pretty early in advancement and pretty easy to handle. If someone else weighs in and I am wrong I stand corrected. T1 would be the smallest cancer. Here is a link to cancer staging explained for you to check out.

    Interesting about your HPV+ coming from your mother, I thought that was just a recent phenomenon. I did not know it went that far back.

    I can only comment on neck dissection, it is not a bad operation at all and recovery is not long, mainly just an incision to heal. I did have tongue surgery with clear margins but it is probably no comparison to base of tongue. I believe the TORs surgery is the best to have because it is the most accurate and causes less collateral damage. So i think you are good there and it looks like you are not listing any follow-up rads or chemo so they must feel confident of getting all the cancer with just the surgery. As far as the carotid ligation I don't know anything about it but I think radiation can affect the carotid artery, I will have to ask my ENT if mine should be checked. I would guess there are some restrictions they want to open up more but I would write down any questions you have and ask the doc to explain the procedure and the risk involved. I hope things go well for you and also hope others on the forum will add in here and be able to give some helpful info. Also as far as the ligation, I looked it up and there is a lot of technical and varied information on it and most I didn't understand. I wouldn't take it lightly though, ask for a complete explanation from your doc. But these days they handle most things very well so as long as you trust and have confidence in your doctors you are good.

    Wishing You the Best

    Take care God Bless-Russ