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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
543
Transoral Robotic Surgery and the Unknown Primary.
Enyinnaya Ofo1, Harry Spiers2, Dae Kim3
1St George's University Hospital and Kingston Hospital NHS Foundation Trusts, London, United Kingdom, Enyinnaya.Ofo@stgeorges.nhs.uk.
ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|November 13, 2018
Summary
Transoral robotic surgery (TORS) for head and neck cancer of unknown primary (CUP) improves occult tumor detection. TORS lingual tonsillectomy or tongue base mucosectomy aids in identifying primary sites, particularly in the oropharynx.
Area of Science:
- Head and Neck Oncology
- Surgical Oncology
- Diagnostic Imaging
Background:
- Carcinoma of unknown primary (CUP) accounts for 1-5% of head and neck cancers.
- Metastatic cervical squamous cell carcinoma (SCC) detection rates are variable, with limitations in current diagnostic imaging.
- Oropharyngeal tumors are the most common primary site for head and neck CUP.
Purpose of the Study:
- To evaluate the role of transoral robotic surgery (TORS) in detecting occult primary tumors in head and neck CUP.
- To present the indications, surgical techniques, evidence, and controversies surrounding TORS for head and neck CUP.
Main Methods:
- Diagnostic surgical efforts focus on sampling the oropharynx.
- Transoral robotic surgery (TORS) enables comprehensive oropharyngeal sampling.
- Specific TORS procedures include lingual tonsillectomy and tongue base mucosectomy.
Main Results:
- TORS-based lingual tonsillectomy or tongue base mucosectomy increases the detection rate of occult tumors in head and neck CUP.
- This approach aids in identifying primary tumor sites previously missed by diagnostic imaging.
Conclusions:
- Transoral robotic surgery (TORS) is a valuable tool for improving primary site detection in head and neck carcinoma of unknown primary (CUP).
- TORS facilitates thorough sampling of the oropharynx, leading to improved diagnostic yield for occult malignancies.
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