Combined transoral transnasal robotic-assisted nasopharyngectomy: a cadaveric feasibility study

Dallan, Iacopo; Castelnuovo, Paolo; Montevecchi, Filippo; Battaglia, Paolo; Cerchiai, Niccolò; Seccia, Veronica; Vicini, Claudio
January 2012
European Archives of Oto-Rhino-Laryngology;Jan2012, Vol. 269 Issue 1, p235
Academic Journal
Surgical management of the nasopharynx is complex. Both traditional and endoscopic transnasal techniques are demanding. Purely transoral robotic nasopharyngectomy has been described but it needs a palatal splitting and is performed with an inferior to superior perspective with a difficult vision of the upper regions. The aim of this study is to investigate a new robotic surgical setting, which is able to overcome the actual limits. The DaVinci Surgical System was used in two cadavers. Dissection was carried out through a combined transnasal-transoral approach and a purely transoral procedure. A complete nasopharyngectomy was performed with both settings. Working and setting times are comparable. The combined approach avoids palatal spitting and permits a more panoramic view of the surgical field with an easier dissection of the upper areas. A robotic palatal sparing nasopharyngectomy is feasible. The combined transnasal-transoral setting seems to offer significant advantages with respect to traditionally purely transoral procedures.


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