Hybrid Operating Room Applications in Otolaryngology: A Seven-Year Single-Center Experience with Image-Guided and...

Background/Objectives: Hybrid operating rooms combine advanced intraoperative imaging, endovascular capabilities, and multidisciplinary resources within a single procedural environment. However, their use in otolaryngology remains insufficiently characterized. This study evaluated institutional patterns of hybrid operating room use, principal clinical indications, multidisciplinary involvement, and perioperative resource utilization in otolaryngology. Methods: We conducted a retrospective single-center study of eligible otolaryngologic procedures performed between 1 October 2018 and 31 December 2025. Patient characteristics, operative sites, hybrid operating room applications, multidisciplinary involvement, intraoperative blood loss, postoperative intensive care unit admission, and length of hospital stay were analyzed. Results: A total of 55 unique procedures were included. The median age was 46.0 years (interquartile range, 33.0-58.5 years; range, 5-76 years), and 33 patients (60.0%) were male. Computed tomography-based localization and navigation represented the predominant application, accounting for nearly three-quarters of procedures. The sinonasal cavity, nasopharynx, and skull base were the most frequently treated anatomical regions, comprising approximately 60% of operative sites. Angiography and endovascular intervention constituted the second most common application. Multidisciplinary collaboration, most frequently involving cardiovascular surgery and interventional radiology, was required in nearly one-quarter of procedures. Procedures relying primarily on intraoperative imaging were associated with a median estimated blood loss of 20 mL and a median hospital stay of 3 days. Cases requiring vascular, cardiopulmonary, or other advanced hybrid capabilities showed greater postoperative resource utilization, including more frequent intensive care admission and longer hospitalization. Conclusions: The hybrid operating room served as a versatile platform for image-guided, vascular, and multidisciplinary procedures in otolaryngology. Its capabilities were used during the management of anatomically complex and high-acuity cases, while differences in postoperative resource utilization appeared to reflect procedural complexity and baseline clinical risk.