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Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer
Mallory Raymond1, Roberto M Soriano2, Ryan Belcher3
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, United States.
Journal of Neurological Surgery. Part B, Skull Base
|July 14, 2022
Summary
The three-dimensional (3D) exoscope is a feasible alternative to the operative microscope for malignant temporal bone resections (TBR). This study shows its potential for complex head and neck cancer surgeries.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Surgical Oncology
Background:
- The three-dimensional (3D) exoscope offers advantages over the operative microscope (OM) but its use in malignant temporal bone resections (TBR) is not well-documented.
- Malignant TBR are complex procedures requiring precise visualization.
Purpose of the Study:
- To assess the feasibility of performing lateral (LTBR) and subtotal (STBR) temporal bone resections using a 3D exoscope for head and neck cancers.
- To evaluate the safety and preliminary outcomes of 3D exoscopic TBR.
Main Methods:
- Retrospective chart review of 55 patients undergoing 3D exoscopic TBR between August 2016 and August 2019.
- Data collected included demographics, tumor characteristics, surgical details, and patient outcomes.
- The Karl Storz VITOM 3D exoscope was used for all procedures.
Main Results:
- 55 patients underwent 3D exoscopic TBR, with 18% (n=10) having STBR.
- The 3D exoscope was used uninterruptedly without intraoperative complications.
- Tumors were predominantly T3 (42%) or T4 (55%), with cutaneous and parotid origins.
- Procedures frequently involved adjunctive resections like infratemporal fossa, mandibulectomy, and parotidectomy.
- Microscopically positive margins were found in 24% (n=13) of cases.
- Recurrence occurred in 20% (n=11) of patients, with a median time of 5 months.
Conclusions:
- The 3D exoscope is a feasible alternative to the OM for LTBR and STBR in malignant cases.
- The technology shows significant potential for complex oncologic head and neck procedures.
- Further investigation is needed to clarify long-term oncologic outcomes.
