Mandibular osteotomy for expanded transoral robotic surgery: a novel technique

Area of Science:

• Surgical Oncology
• Robotic Surgery
• Otolaryngology

Background:

• Transoral Robotic Surgery (TORS) offers a safe and effective approach for oropharyngeal malignancies.
• Anatomical limitations like retrognathia or macroglossia can restrict TORS access.
• A modified TORS approach is proposed to overcome these access challenges.

Purpose of the Study:

• To evaluate the efficacy of transoral mandibular osteotomies in improving surgical exposure for TORS.
• To determine if this modified approach can expand TORS candidacy for patients with anatomical limitations.

Main Methods:

• Five experimental procedures were conducted on cadavers.
• Measurements of retractor opening and oral cavity exposure were taken before and after mandibular osteotomies.
• Techniques included lateral cephalography, acoustic pharyngometry, and high-resolution photography.

Main Results:

• All specimens demonstrated increased retractor opening after mandibular osteotomies.
• Transoral exposure and access to the oral cavity were significantly improved.
• The modified approach enhanced visualization of oropharyngeal subsites.

Conclusions:

• Transoral mandibular osteotomies effectively increase surgical exposure in the oral cavity.
• This technique can potentially expand the patient population eligible for TORS.
• The modified TORS approach shows promise for improving access to oropharyngeal lesions and the larynx.