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- Title
Mandibular Osteotomy for Expanded Transoral Robotic Surgery: A Novel Technique.
- Authors
Iloreta, Alfred Marc C.; Anderson, Katie; Miles, Brett A.
- Abstract
Objectives/Hypothesis: 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. Study Design: Five experimental procedures were performed on five cadavers. Methods: 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. Results: An increase in retractor opening, transoral exposure, and oral cavity was observed in all specimens. Conclusions: Mandibular osteotomies increase exposure to oral cavity and oropharyngeal lesions in the setting of TORS.
- Subjects
OSTEOTOMY; MANDIBULAR prosthesis; SURGICAL robots; OROPHARYNGEAL cancer; OROPHARYNX; SURGERY
- Publication
Laryngoscope, 2014, Vol 124, Issue 8, p1836
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.24579