Mandibular osteotomy for expanded transoral robotic surgery: A novel technique. (10th February 2014)

• Record Type: Journal Article
• Authors: Iloreta, Alfred Marc C.; Anderson, Katie; Miles, Brett A.
• Is Part Of: Laryngoscope. Volume 124:Number 8(2014:Aug.)
• Page Start: 1836
• Page End: 1842
• Publication Date: 2014-02-10
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24579
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24579-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>Transoral Robotic Surgery (TORS) has revolutionized the surgical treatment of malignant lesions of the oropharyngeal region. Recent studies have shown that this approach is a very safe procedure and can provide favorable clinical and functional outcomes with respect to traditional approaches. However, a small minority of patients who present with lesions amenable to TORS resection may not be candidates due to anatomical access issues. Anatomic features such as a retrognathic mandible, macroglossia, trismus, dentition, and small oral aperture limit the ability to perform TORS with current technology. We propose a modified TORS approach in which transoral mandibular osteotomies are performed that can greatly improve exposure to oropharyngeal subsites and expand access to the larynx in selected patients.</p> </sec> <sec id="lary24579-sec-0002" sec-type="section"> <title>Study Design</title> <p>Five experimental procedures were performed on five cadavers.</p> </sec> <sec id="lary24579-sec-0003" sec-type="section"> <title>Methods</title> <p>Five cadavers were obtained for the investigation. Measurements including retractor opening, lateral cephalography, acoustic pharyngometry, and high‐resolution photographs were taken prior to mandibular osteotomies and then repeated following the osteotomies.</p> </sec> <sec id="lary24579-sec-0004" sec-type="section"> <title>Results</title> <p>An increase in retractor opening, transoral exposure, and oral cavity was observed in all specimens.</p> </sec> <sec id="lary24579-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Mandibular osteotomies increase exposure to oral cavity and oropharyngeal lesions in the setting of TORS.</p> </sec> <sec id="lary24579-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>N/A. <italic>Laryngoscope</italic>, 124:1836–1842, 2014</p> </sec> </abstract>