Transoral Robotic Cleft Palate Surgery: Communication-Related Outcomes and Feasibility

Area of Science:

• Craniofacial Surgery
• Robotic Surgery
• Pediatric Otolaryngology

Background:

• Cleft palate repair aims to improve communication outcomes, including speech and otological health.
• Robot-assisted surgery offers potential advantages for complex reconstructive procedures like transoral cleft palate repair.

Purpose of the Study:

• To investigate if robot-assisted transoral cleft palate repair improves communication outcomes compared to conventional surgery.
• To review the current literature on the efficacy of transoral robotic cleft surgery (TORCS) for speech and otological outcomes.

Main Methods:

• A structured literature review was conducted using major biomedical databases (PubMed, Embase, Cochrane Library, Google Scholar).
• Included studies compared robot-assisted transoral cleft palate surgery with conventional manual techniques.
• Primary outcomes assessed were changes in cleft speech characteristics and otological disease post-surgery.

Main Results:

• Limited evidence exists for communication outcomes in TORCS.
• One study reported TORCS significantly reduced otitis media with effusion, ventilation tube need, and hearing thresholds within two years.
• No postoperative speech or velopharyngeal outcomes were reported in the included studies.

Conclusions:

• TORCS is safe and feasible for cleft palate repair, offering improved visualization and ergonomics.
• Current limitations include cost, available tools, longer duration, and lack of haptic feedback.
• TORCS may aid Eustachian tube function and hearing recovery, but speech outcome data is insufficient.