“The emergence of endoscopic head and neck surgery.”
Holsinger, F. C., A. D. Sweeney, et al. (2010).
Current Oncology Reports 12(3): 216-222.
Endoscopic and minimally invasive techniques represent a natural evolution for the discipline of head and neck surgery. Endoscopic head and neck surgery (eHNS) encompasses transoral laser microsurgery, transoral robotic surgery, as well as video-assisted and robotic surgery of the neck and thyroid. In the next 5 years, with robotic surgery and laser technology as a common platform, we foresee the development and widespread use of eHNS procedures, via transoral and transaxillary approaches.
“Da Vinci Robot-Assisted Transoral Odontoidectomy for Basilar Invagination.”
Lee, J. Y., B. Lega, et al. (2010).
ORL; Journal of Oto-Rhino-Laryngology and Its Related Specialties 72(2): 91-95.
The transoral approach is an effective way to decompress the craniocervical junction due to basilar invagination. This approach has been described and refined, but significant limitations and technical challenges remain. Specifically, should the transoral route be used for intradural pathology, such as a meningioma, or should an inadvertent durotomy occur during extradural dissection, achieving a watertight closure of the dura in such a deep and narrow working channel is limited with the current microscopic and endoscopic techniques. Even closure of the posterior pharyngeal mucosa can be challenging, and problems with wound dehiscence encountered in some case series may be attributable to this difficulty. These problems, and the corollary aversion to the procedure felt by many neurosurgeons, led our group to investigate an alternative approach.
“Robotic surgery allows tailored therapy for oropharyngeal Ca.”
London, S. (2010).
Oncology Report(MARCH-APRIL): 28-29.