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Related Experiment Video

Updated: Jun 4, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

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Concurrent neck dissection and transoral robotic surgery.

Eric J Moore1, Kerry D Olsen, Eliot J Martin

  • 1Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA. moore.eric@mayo.edu

The Laryngoscope
|February 24, 2011
PubMed
Summary

Pharyngeal communication with the neck is common during transoral robotic oropharyngectomy with neck dissection, but persistent fistula is rare. Prompt management ensures comparable functional outcomes and avoids adjuvant therapy delays.

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Area of Science:

  • Otolaryngology
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Transoral robotic surgery (TORS) is increasingly used for oropharyngeal cancers.
  • Concurrent neck dissection is often necessary but may increase complication risks.
  • Pharyngocutaneous fistula is a concern when combining TORS with neck dissection.

Purpose of the Study:

  • To determine the incidence of pharyngocutaneous fistula after TORS with concurrent neck dissection.
  • To discuss prevention and management strategies for this complication.

Main Methods:

  • Retrospective review of 148 patients undergoing TORS and neck dissection for oropharyngeal neoplasia.
  • Analysis of intraoperative findings and postoperative outcomes related to orocervical communication.

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Main Results:

  • Twenty-nine percent (42/148) had intraoperative orocervical communication, managed conservatively.
  • Four percent (6/148) developed fluid accumulation requiring drainage.
  • All patients achieved comparable aesthetic and functional results without adjuvant therapy delays.

Conclusions:

  • Orocervical communication is common in TORS with concurrent neck dissection.
  • Persistent pharyngocutaneous fistula is an uncommon but preventable complication.
  • Prompt recognition and intervention are crucial for optimal patient outcomes.