Transoral robotic cricopharyngeal myectomy for cricopharyngeal muscle spasm

This case report details the innovative use of transoral robotic surgery (TORS) for cricopharyngeal (CP) myectomy, a procedure that has never been documented for this condition. Our patient, who was previously treated for tongue cancer by total glossectomy, experienced persistent dysphagia and received gastric tube feeding despite multiple rehabilitations. After botulinum toxin injection confirmed CP muscle spasm, a TORS CP myectomy was performed using the da Vinci Si robotic system. The procedure involved a minimally invasive transoral approach, providing high-magnified 3D panoramic visualization, precise resection of a CP muscle segment and re-approximation of the post-hypopharyngeal mucosa. Postoperatively, the patient showed significant improvement in swallowing function, evidenced by successful removal of the feeding tube and improved videofluoroscopy results. This case report explains why we think TORS CP myectomy could be a feasible alternative to other existing methods.