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Pediatric Robotic Laryngeal Cleft Repair.

Cameron P Worden1, Andrew C Prince1, Samuel N Kirse1

  • 1Department of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 15, 2024
PubMed
Summary

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Robotic laryngeal cleft (LC) repair shows improved swallowing outcomes, especially for recurrent cases, despite longer operative times for Type I LC. This approach may offer benefits for complex LC repairs.

Area of Science:

  • Pediatric surgery
  • Otolaryngology
  • Minimally invasive techniques

Background:

  • Laryngeal cleft (LC) repair aims to improve swallowing and reduce aspiration.
  • Traditional surgical methods for LC repair include open and endoscopic approaches.
  • Robotic surgery offers potential advantages in precision and visualization for complex procedures.

Purpose of the Study:

  • To compare surgical and swallowing outcomes between robotic and traditional laryngeal cleft (LC) repairs in pediatric patients.
  • To evaluate the efficacy of robotic-assisted LC repair for different cleft types and recurrent cases.

Main Methods:

  • Retrospective cohort study conducted at a tertiary care pediatric hospital.
  • Included pediatric patients who underwent robotic or traditional LC repair between 2010 and 2021.
Keywords:
LCMBSScleftendoscopiclaryngealrobotictraditional

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  • Compared patient characteristics, operative times, adverse events, hospital length of stay (LOS), and modified barium swallow study (MBSS) results.

    • Main Results:

    • Robotic Type I LC repairs had longer surgical and OR times but improved 12-month MBSS outcomes compared to traditional repairs.
    • Robotic Type II and III LC repairs showed decreased hospital LOS and trending improvements in MBSS.
    • Robotic surgery successfully revised all recurrent LC cases that failed traditional repairs.

    Conclusions:

    • Robotic LC repair, particularly for Type I, offers improved postoperative swallowing outcomes despite increased operative time and LOS.
    • The robotic approach may be especially beneficial for managing recurrent laryngeal clefts.
    • Further research with larger cohorts is needed to confirm benefits for Type II and III LC repairs.