Asit Arora1, Jalpa Kotecha1, Amish Acharya1, George Garas1, Ara Darzi2, D Ceri Davies3, Neil Tolley1. 1. Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 2. Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom. 3. Human Anatomy Unit, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital Campus, London, United Kingdom.
Abstract
BACKGROUND: Transoral robotic surgery (TORS) represents a novel treatment for oropharyngeal cancer and obstructive sleep apnea. Appropriate patient selection is crucial. The purpose of this study was to investigate whether anatomic biometric measures are useful to determine the feasibility of performing TORS. METHODS: Three surgeons independently evaluated feasibility in 51 soft-fix cadavers. Transoral visualization was performed with 2 retractors commonly used in TORS. Seven anthropometric parameters and the degree of mouth opening were recorded. RESULTS: Mandibular body height, hyoid-mental length, and neck circumference demonstrated significant differences between "suboptimal" and "adequate" visualization of base of tongue and epiglottis (p < .05). Limited mouth opening was associated with suboptimal visualization. Neck circumference had the strongest influence on predicting TORS feasibility. CONCLUSION: Mandibular body height, hyoid-mental length, and neck circumference in conjunction with the degree of mouth opening may determine patient suitability for TORS. Clinical evaluation is essential to validate their collective usefulness.
BACKGROUND: Transoral robotic surgery (TORS) represents a novel treatment for oropharyngeal cancer and obstructive sleep apnea. Appropriate patient selection is crucial. The purpose of this study was to investigate whether anatomic biometric measures are useful to determine the feasibility of performing TORS. METHODS: Three surgeons independently evaluated feasibility in 51 soft-fix cadavers. Transoral visualization was performed with 2 retractors commonly used in TORS. Seven anthropometric parameters and the degree of mouth opening were recorded. RESULTS: Mandibular body height, hyoid-mental length, and neck circumference demonstrated significant differences between "suboptimal" and "adequate" visualization of base of tongue and epiglottis (p < .05). Limited mouth opening was associated with suboptimal visualization. Neck circumference had the strongest influence on predicting TORS feasibility. CONCLUSION: Mandibular body height, hyoid-mental length, and neck circumference in conjunction with the degree of mouth opening may determine patient suitability for TORS. Clinical evaluation is essential to validate their collective usefulness.
Authors: George Garas; Nick J Roland; Jeffrey Lancaster; Matthew Zammit; Victoria A Manon; Katharine Davies; Terry M Jones; Mriganka De; Floyd C Holsinger; Robin J D Prestwich; Jason C Fleming Journal: Ann Surg Oncol Date: 2022-07-16 Impact factor: 4.339
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