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Background and Objectives:Surgery and postoperative radiation therapy have been the main stream management of tonsil cancer. There is a variety of surgical approach methods are used for the resection of tonsil cancer, however, there have only been of our surgical treatments of tonsil cancer. Subjects and Method:32 medical records, from 1994 April to 2003 June, of patients surgicaly treated for tonsil cancer were reviewed. Evaluated were disease status, surgical approach methods, types of the neck dissection, surgical margin, reconstruction methods, postoperative complications, time of oral diet and decannulation, recurence, and survival rate. Results:Mean follow up periods were 2.3 years. There was 1 patient in Stage I, 5 in Stage II, 2 in Stage III, pharyngotomy approach. Surgical defects were primary closed in 5 patients and reconstructed with pectoralis major myocutaneous flap in 7 patients and radial forearm fasciocutaneous free flap in 20 patients. There were 2 local recurences, 5 regional recurrences, and one distant metastasis. The mean time of the beginning of oral diet/decannulation after operation were 19.8/11.3 days in lateral pharyngotomy and 25.3/12.9 days in mandibulotomy. The mean survival period was 41.4 months. Conclusion:Because pharyngotomy approach had priority to other surgical approaches in selected cases except T4. It has advantages of full range of vision for resection, better functional status and less postoperative morbidity. (Korean J Otolaryngol 2004 ;47 :168-73)

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