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Article Transoral Robotic Surgery (TORS) for Head and Neck Cancer in the Elderly Population: Functional Outcomes, Survival, and Complications(Wiley, 2025) Pamuk, Erim; Beharry, Avinash; Lambercy, Karma; Dalla-Vale, Margaux; Wahler, Nina; Hosal, Sefik; Simon, ChristianObjective: To compare functional and oncologic outcomes in elderly (>= 70 years) and nonelderly (< 70 years) patients after transoral robotic surgery (TORS). Methods: A retrospective chart review was conducted on 114 patients who underwent TORS for head and neck squamous cell carcinoma between 2012 and 2022. Patient and tumor characteristics, perioperative details, complications, and survival parameters were analyzed. Swallowing function was assessed using the Functional Outcome Swallowing Scale (FOSS). Results: Of the 114 patients, 37 (32.5%) were elderly, and 77 (67.5%) were nonelderly. Elderly patients had higher comorbidity scores (p < 0.001). Oropharyngeal and oral cavity primaries were more common in the nonelderly group, whereas laryngeal primaries predominated in elderly patients (p < 0.01). Complication rates were higher in nonelderly (37.6%) than in elderly (18.9%) patients, though not statistically significant (p = 0.07). In elderly patients, FOSS scores showed no significant change preoperatively, postoperatively (< 3 months), or at the last follow-up (median 36 months). The nonelderly group experienced worse early postoperative FOSS scores compared to baseline but showed significant improvement, returning to preoperative levels by the last follow-up. Nonelderly patients had better FOSS scores at last follow-up compared to elderly patients (p = 0.014). Overall and recurrence-free survival outcomes were better in the nonelderly group, but disease-specific survival rates were comparable. Conclusion: Despite higher comorbidity rates in the elderly, TORS demonstrated favorable complication rates in the elderly population. Swallowing function returned to baseline after 3 months in both groups. TORS appears safe for elderly patients with comparable oncologic outcomes.Article Diagnostic Value of Thyroid Physical Examination in the Elderly and Comparison with Ultrasonography(UK Scientific Publishing Ltd, 2025) Gulmez, Mehmet Ihsan; Aydin, CansetThis study is part of the health project called "Health screening for the elderly in Ankara" for patients aged 65 and over, with 1200 participants. Patients with missing laboratory tests (n = 59), movement disorders and/or bedridden (n = 54) were excluded from the study. PE was performed by a geriatrician or an ear, nose, and throat surgeon, and ultrasonographic evaluation was performed by a radiologist. PE and USG findings were compared. We aimed to investigate the diagnostic accuracy of physical examination (PE) of the thyroid gland (TG) in patients over 65 years of age and to assess the reliability by comparing PE with ultrasonographic (USG) examination. The median age of the patients participating in the study was 71.17. When the differences between thyroid nodules (TN), the number of TN size, and goiter detection were compared in terms of PE and USG, all values were statistically signifi- cant, and P values were < 0.001. The sensitivity of PE of TG was calculated as 31.0%. In our study, the sensitivity of PE of TG in terms of TN and goiter was found to below. The diagnostic accuracy of PE of TG is low, and therefore, its impact on clinical decision-making is limited. Furthermore, detected nodules rarely progress to clinically relevant disease, leading to overdiagnosis and overtreatment. Especially in groups at risk for nodules and malignancy, PE must be combined with imaging methods and, if necessary, pathological examination, even if nodules or goiter are not palpable in PE.
