title: Combined transoral transnasal robotic-assisted nasopharyngectomy: a cadaveric feasibility study.
abstract: 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.
authors.affiliation: Otorhinolaryngologic Unit, University of Insubria, Varese, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Dallan
authors.forename: Paolo
authors.initials: P
authors.lastname: Castelnuovo
authors.forename: Filippo
authors.initials: F
authors.lastname: Montevecchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Battaglia
authors.forename: Niccolò
authors.initials: N
authors.lastname: Cerchiai
authors.forename: Veronica
authors.initials: V
authors.lastname: Seccia
authors.forename: Claudio
authors.initials: C
authors.lastname: Vicini
mesh_terms: D002102:Cadaver; D005240:Feasibility Studies; D006801:Humans; D009305:Nasopharynx / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012371:Robotics / Q000379:methods*