Thematic evolution and global trends in retroauricular and robotic-assisted surgery: a comprehensive bibliometric...

Despite the increasing clinical adoption of robotic retroauricular (RA) surgery, there has been limited bibliometric examination of its global research evolution. This study represents the first comprehensive bibliometric investigation of the field, aiming to map publication activity, leading contributors, citation performance, and thematic development within this specialized surgical domain. A comprehensive bibliometric analysis was performed using the Scopus database. Two sequential search strategies were applied: a broad query targeting all retroauricular-related surgical research, and a refined search focusing specifically on robotic retroauricular procedures. The initial broad search retrieved 1808 documents, including 1,582 articles and 92 reviews. After filtering, 1,249 records (1,171 articles; 78 reviews) were analyzed. Annual output increased from 13 papers in 2001 to 70 in 2025, peaking in 2022 (74 papers). The most prolific authors were Koh Y.W. (38 papers), Choi E.C and Byeon H.K . Leading institutions included Yonsei University College of Medicine (43 papers) and Peking Union Medical College , while the United States (174), China (131), and South Korea (119) were top contributing countries. The refined robotic-specific query yielded 144 documents, of which 115 (90 articles; 25 reviews) were eligible for analysis. Research output spanned 2009-2025, with early activity emerging in 2009-2012 and a marked rise from 2015 onward, peaking at 17 papers in 2020. South Korea led with 45 publications, followed by the United States and India . The most active institutions were Yonsei University College of Medicine [Sharma in Ann Otol Rhinol Laryngol 125(3):207-212] and A.C. Camargo Cancer Center [Lee in Ann Surg Oncol 19:3871-3877]. Thematic progression from 2009 to 2025 showed a clear evolution in retroauricular and robotic head and neck surgery. Early studies focused on anatomical access and cosmetic incision design, forming the basis for concealed approaches such as retroauricular and transaxillary routes. Between 2012 and 2015, research advanced toward robotic feasibility, comparative safety, and reconstructive integration. From 2016 to 2019, emphasis shifted to clinical adoption and technical refinement, including endoscopic dissection and standardized procedures. The 2020-2022 period marked functional validation, meta-analyses, and broader applications in salivary, thyroid, and pediatric surgery, introducing single-port and hybrid systems. From 2023 onward, studies highlighted learning curves, outcome comparisons, and system innovations. By 2025, the field reached procedural maturity, defined by precision, adaptability, and cosmetic excellence. This study provides the first structured bibliometric framework for understanding the global evolution of robotic retroauricular surgery.