ABSTRACT
Recognized for millennia, oropharyngeal malignancies have become commonplace only in recent centuries due to longer life expectancies and widespread tobacco abuse. Surgical resection of the oropharyngeal primary was attempted only by those of exceptional fortitude before the advent of modern anesthesia. In the early 19th century, Sedillot described an early mandibular swing approach, splitting the lip, mandible and floor of mouth on a conscious, restrained patient 1 . Such heroic efforts were extraordinarily morbid and disfiguring, and offered poor oncological control. Exsanguination and tracheotomy were common, as were postoperative infection, dysarthria and dysphagia. For decades, surgeons and patients alike approached oropharyngeal cancer with great timidity. General Ulysses S Grant died in 1885 having slowly succumbed to tonsillar squamous cell carcinoma (SCC) with only symptomatic treatment.
