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Arch Otolaryngol Head Neck Surg. 2007 Dec;133(12):1220-6.

Transoral robotic surgery: radical tonsillectomy.

Author information

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. gregory.weinstein@uphs.upenn.edu

Abstract

OBJECTIVE:

To describe and show the feasibility of a new surgical technique for transoral robotic surgery (TORS) radical tonsillectomy.

DESIGN:

A prospective, phase 1 clinical trial.

SETTING:

Academic, tertiary referral center.

PATIENTS:

A total of 27 participants were prospectively selected using a volunteer sample. All eligible patients agreed to participate in the study.

INTERVENTIONS:

Patients underwent TORS radical tonsillectomy for previously untreated invasive squamous cell carcinoma of the tonsillar region without free-flap reconstruction, staged neck dissection, and adjuvant therapy.

MAIN OUTCOME MEASURES:

Outcome measures included final pathologic margin status, need for short- and long-term tracheotomy tube placement, and need for gastrostomy tube feedings among patients with a minimum 6-month follow-up. The incidence of significant postoperative complications was recorded.

RESULTS:

No mortality occurred. Final margins found to be negative for cancer were achieved in 25 of 27 patients (93%). Surgical complications included 1 case each of postoperative mucosal bleeding, delirium tremens, unplanned tracheotomy for temporary exacerbation of sleep apnea, and hypernasality and 2 cases of moderate trismus. Twenty-six of 27 patients (96%) were swallowing without the use of a gastrostomy.

CONCLUSIONS:

Radical tonsillectomy using TORS is a new technique that offers excellent access for resection of carcinomas of the tonsil with acceptable acute morbidity. Future reports will focus on long-term oncologic and functional outcomes.

PMID:
18086963
[PubMed - indexed for MEDLINE]
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