Gerald Tay1, Jay Ferrell1, Peter Andersen1. 1. Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.
Abstract
BACKGROUND: The utilization of transoral robotic surgery (TORS) in patients with trismus is limited because of poor surgical exposure. METHODS: This report is about a 46-year-old man with a recurrent right base of tongue cancer who had severe postradiation trismus. We performed a midline mandibular osteotomy without a lip split and this resulted in a markedly improved surgical exposure. He underwent a TORS resection of the right base of the tongue with no significant complications. RESULTS: The midline mandibular osteotomy significantly improved the surgical exposure and facilitated exposure for TORS in a patient who otherwise would not be able to undergo TORS. CONCLUSION: Utilization of a midline mandibular osteotomy allowed for increased exposure for TORS in a patient with limited mouth opening from postradiation trismus. Postoperative hemorrhage remains a significant concern and appropriate measures to mitigate the catastrophic consequences of this should be considered.
BACKGROUND: The utilization of transoral robotic surgery (TORS) in patients with trismus is limited because of poor surgical exposure. METHODS: This report is about a 46-year-old man with a recurrent right base of tongue cancer who had severe postradiation trismus. We performed a midline mandibular osteotomy without a lip split and this resulted in a markedly improved surgical exposure. He underwent a TORS resection of the right base of the tongue with no significant complications. RESULTS: The midline mandibular osteotomy significantly improved the surgical exposure and facilitated exposure for TORS in a patient who otherwise would not be able to undergo TORS. CONCLUSION: Utilization of a midline mandibular osteotomy allowed for increased exposure for TORS in a patient with limited mouth opening from postradiation trismus. Postoperative hemorrhage remains a significant concern and appropriate measures to mitigate the catastrophic consequences of this should be considered.