Review of recent advancements in oropharyngeal reconstruction for transoral robotic surgery defects: emerging techniques, functional preservation, and technological innovations

PURPOSE OF REVIEW: The dynamic reconstruction of oropharyngeal defects demands tailored solutions that balance functional, aesthetic, and oncologic priorities. This review synthesizes advancements in reconstructive techniques over the last 18 months, contextualized within the evolving landscape of oropharyngeal disease, and highlights innovations that prioritize both surgical efficacy and quality of life. RECENT FINDINGS: Recent studies underscore the importance of tailored, functionally focused reconstructive strategies, integrating robotic-assisted surgery and tunneled, folded, or super-thin flaps. Buccinator myomucosal and lateral arm flaps have garnered attention for their versatility and low morbidity, while platelet-rich fibrin and tissue plug modifications have shown promise in reducing common reconstructive complications such as pharyngocutaneous fistulas. Other studies have addressed the impact of prior or upcoming radiation on reconstructive approach. Many emphasize quality of life and aesthetic measures, representing a shift toward survivorship over solely objective outcomes. SUMMARY: Modern oropharyngeal reconstruction emphasizes patient-specific and function-preserving strategies that necessitate biologic adjuncts and nuanced surgical planning. However, the lack of prospective studies, standardized outcome measures, and comparator groups underscores the need for future research to ensure broader applicability and improved reliability of these approaches.