Central neck dissection via the transoral approach

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Minimally invasive surgical approaches are increasingly sought to reduce patient morbidity.
• Transoral neck surgery (TONS) has emerged as a remote access technique for head and neck procedures.
• Minimizing visible scarring is a key patient concern driving innovation in neck surgery.

Purpose of the Study:

• To evaluate the safety and efficacy of transoral neck surgery (TONS) for central neck dissection (CND).
• To highlight the unique advantages of TONS in providing bilateral visualization for CND.
• To establish recommendations for the appropriate use of TONS in CND.

Main Methods:

• Review of existing literature and surgical techniques for TONS.
• Analysis of TONS's effectiveness in thyroidectomy, parathyroidectomy, and CND.
• Comparison of TONS with other remote access techniques for neck surgery.

Main Results:

• TONS provides midline access with equivalent visualization of bilateral thyroid lobes and paratracheal basins.
• TONS is safe and effective for endoscopic and robotic thyroidectomy, parathyroidectomy, and CND.
• TONS offers familiar views of recurrent laryngeal nerves and access to paratracheal basins, facilitating comprehensive CND.

Conclusions:

• Central neck dissection (CND) via TONS is feasible and safe but not universally indicated.
• CND via TONS should be performed concurrently with transoral total thyroidectomy.
• Recommendations for TONS-guided CND align with AHNS consensus statements and TONS indications.