14, 15 While avoiding functional deficits from the traditional external approaches, TORS can reduce the need for adjuvant therapy after surgery or can use surgery as a single-technique therapy while preserving oncologic outcomes, particularly when the negative margin is achieved by TORS. 10 ⇓ ⇓– 13 Recently, transoral robotic surgery (TORS) has emerged as a first-line treatment, particularly for early-stage HPV-positive oropharyngeal SCC. 7 ⇓- 9 Long-term adverse effects from radiation or chemotherapy and high morbidity from traditional surgery through external mandibulotomy can reduce the quality of life, particularly in young patients who have to live with the consequences for far longer. The treatment protocol for HPV-positive SCC has shifted toward a “deintensification” approach to maintain favorable oncologic outcomes while minimizing treatment-related morbidity. 3 ⇓- 5 Surgery, radiation, and chemotherapy are the main treatment methods for oropharyngeal SCC and can be used alone or in combination depending on the cancer stage. 1, 2 HPV-positive oropharyngeal SCC is known for its excellent prognosis with substantially improved survival compared with HPV-negative SCC. Oropharyngeal squamous cell carcinoma (SCC) is a head and neck cancer with increasing prevalence as a consequence of rising human papillomavirus (HPV) infections. The injection of dye into the inferior thyroid artery can be used as an alternate method in identification the recurrent laryngeal nerve.ABBREVIATIONS: AUC area under the curve cN clinical node cT clinical tumor HPV human papillomavirus pN pathologic node pT pathologic tumor ROC receiver operating characteristic SCC squamous cell carcinoma TORS transoral robotic surgery Also as the parathyroid is mainly supplied by inferior thyroid artery accidental ligation during thyroidectomy can cause hypoparathyroidism. This makes it vulnerable to injury during surgery that involves ligating the inferior thyroid artery, such as excision of the lower pole of the thyroid gland. The recurrent laryngeal nerve passes upward generally behind, but occasionally in front of, the inferior thyroid artery. The relationship between the recurrent laryngeal nerve and inferior thyroid artery is highly variable. The glandular branches of the inferior thyroid artery are small branches which directly supply the thyroid gland. The pharyngeal branches of the inferior thyroid artery supply the pharynx. It then anastomoses with the ascending pharyngeal and occipital arteries. One or two spinal branches are sent into the spinal canal, through the intervertebral foramina to be distributed to the spinal cord and its membranes, and to the bodies of the vertebrae. The ascending cervical artery gives twigs to the neck muscles and these anastomose with branches of the vertebral arteries. The ascending cervical artery is a small branch which arises from the inferior thyroid artery as it passes behind the carotid sheath it runs up on the anterior tubercles of the transverse processes of the cervical vertebrae in the interval between the anterior scalene muscle and the longus capitis. The esophageal branches of the inferior thyroid artery supply the esophagus, and anastomose with the esophageal branches of the aorta. The tracheal branches of the inferior thyroid artery are distributed on the trachea, and anastomose below with the bronchial arteries. It is accompanied by the recurrent nerve, and supplies the muscles and mucous membrane of this part, anastomosing with the branch from the opposite side, and with the superior laryngeal branch of the superior thyroid artery. The inferior laryngeal artery climbs the trachea to the back part of the larynx under cover of the inferior pharyngeal constrictor muscle. The branches of the inferior thyroid artery are the inferior laryngeal, the oesophageal, the tracheal, the ascending cervical and the pharyngeal arteries. Reaching the lower border of the thyroid gland it divides into two branches, which supply the postero-inferior parts of the gland, and anastomose with the superior thyroid artery, and with the corresponding artery of the opposite side. It then turns medially behind the carotid sheath and its contents, and also behind the sympathetic trunk, the middle cervical ganglion resting upon the vessel. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle. The inferior thyroid artery is an artery in the neck.
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