In December 2019, an outbreak of pneumonia of unknown origin was observed in the city of Wuhan, Hubei Province, China. A novel coronavirus, the 2019 new coronavirus, then named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the etiologic agent responsible for the outbreak.^1,2 Coronavirus disease 2019 (COVID-19) then spread outside Hubei to many countries outside China. It was defined as a pandemic by the World Health Organization on March 11, 2020.³

Research from JAMA Facial Plastic Surgery — Anterior Ethmoidal Artery Septal Flap for the Management of Septal Perforation

The aim of this systematic review with meta-analysis was to investigate the available literature on transoral approaches in the treatment of hypopharyngeal squamous cell carcinoma, with a special focus on transoral robotic surgery (TORS). A systematic review was conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) check-list, and 15 studies were included. Five of the included studies evaluated TORS, while ten studies focused on transoral laser microsurgery (TLM) for the treatment of early or advanced stage hypopharyngeal cancer. Overall, survival rates of TLM and TORS studies, analyzed together in the cumulative meta-analysis, were 66.4% (95% confidence interval (CI) 54.3%–76.7%) at 36+ months of follow up. The TORS subgroup showed a higher cumulative survival rate (85.5%, 95% CI 55.8%–96.5%) compared to TLM (58.5%, 95% CI 46.6%–69.6%). Cumulative data showed that 29.3% (95% CI 24.0%–35.3%) of deaths were attributable to cancer. The results were similar between TLM and TORS studies. The larynx function preservation cumulative rate was 94.3% (95% CI 91.8%–96.1%). The results were similar among the two subgroups. The present review supports the use of transoral approaches in the treatment of hypopharyngeal cancer. TORS is oncologically sound and provides excellent functional results with low complication rates.