Following the inception of transoral robotic surgery (TORS) in 2005, the field of robotic head and neck surgery has undergone refinement and innovation. Optimizing patient outcome, preserving function, and limiting morbidity are the key drivers. The next leap forward is another generation of flexible robotic surgical systems. Several such systems are under clinical and preclinical evaluation. A new single-port (Sp) robotic surgical architecture is now available integrating three fully articulating instruments and a flexible three-dimensional high-definition camera delivered through a 25-mm cannula. Preclinical feasibility studies of the Sp in human cadaver and porcine models suggest improved application compared to existing platforms for oropharyngeal and nasopharyngeal resection. With 3-handed manipulation of tissue, traction and countertraction may be used to deliver a more precise surgical dissection of head and neck anatomy than is currently possible. The single-port design permits greater access and maneuverability for the bedside surgical assistant. An alternative currently available in clinical use includes the Flex® system using a robotic camera and manually controlled endoscopic instruments. The Cambridge Medical Robotics Versius system is undergoing preclinical evaluation for TORS and may offer a novel modular approach. All of these systems allow the head and neck surgeon to reach further beyond the upper aerodigestive tract with greater agility and precision, expanding the boundaries of minimal access head and neck surgery.
Intensity-modulated radiotherapy with or without systemic therapy is the recommended treatment approach for patients with oropharyngeal squamous cell carcinoma (OPSCC) (National Comprehensive Cancer Network 2019). Despite its effectiveness, approximately 20% of patients recur after treatment, resulting in a poor prognosis with a median overall survival (OS) time of 10 months (Bird et al.,
Few studies have evaluated the degree of xerostomia in long-term cancer survivors or its impact on quality of life (QOL). The purpose of this study was to objectively measure the degree of xerostomia and to determine the effect of xerostomia POSTERS Otolaryngology-Head and Neck Surgery Volume 131 Number 2 Research Posters P183
This study examines preoperative clinical characteristics that can be used to predict secure inferior margins of glottic squamous cell carcinoma (SCC) extending toward the cricoid cartilage, when performing organ preservation surgery of the larynx.Methods: Thirty-one serially sectioned whole-organ laryngectomies were histologically analyzed and true vocal cord (TVC) mobility, cricoarytenoid joint invasion, subglottic extension (SGE) of tumor, and prior radiation were examined as independent and multivariate correlates of cricoid invasion.Results: All tumors with SGE.
Conclusion:Preoperative assessment of arytenoid mobility and extent of SGE are reliable predictors of cricoid invasion by glottic SCC.Significance: Organ preservation surgery is oncologically safe in the setting of glottic SCC with SGE.
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