title: Transoral robotic surgery: role in the management of upper aerodigestive tract tumors.
abstract: The toxicity associated with concomitant chemoradiation for the management of laryngeal and pharyngeal carcinoma has been well documented. Minimally invasive surgical techniques offer the potential to extirpate the malignancy as a single-modality therapy and provide essential information that may direct subsequent treatment. In selected patients, radiation doses may be reduced and systemic chemotherapy may be withheld after tumor extirpation. Transoral laser microsurgery has proven effective, although inability to manipulate and suture tissue by this modality limits ablation and reconstruction of extensive defects. Transoral robotic surgery is a relatively new technique that provides several unique advantages, which include a 3-dimensional magnified view, ability to see and work around curves or angles, and the availability of 2 or 3 robotic arms that can be used to reconstruct extensive defects using either local, regional, or free flaps. Preliminary data suggest that transoral robotic surgery may provide a technique for ablation and reconstruction of pharyngeal defects that may be superior to other transoral techniques. It may also provide a means for personalizing therapy for oropharyngeal and supraglottic carcinoma.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Mount Sinai Medical Center, New York, NY, USA. Eric.Genden@mountsinai.org
authors.forename: Eric M
authors.initials: EM
authors.lastname: Genden
authors.forename: Bert W
authors.initials: BW
authors.lastname: O'Malley
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Weinstein
authors.forename: Chaz L
authors.initials: CL
authors.lastname: Stucken
authors.forename: Jesse C
authors.initials: JC
authors.lastname: Selber
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.forename: Neil G
authors.initials: NG
authors.lastname: Hockstein
authors.forename: Enver
authors.initials: E
authors.lastname: Ozer
authors.forename: Yann
authors.initials: Y
authors.lastname: Mallet
authors.forename: Richard M
authors.initials: RM
authors.lastname: Satava
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Moore
authors.forename: Carl E
authors.initials: CE
authors.lastname: Silver
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
mesh_terms: D017024:Chemotherapy, Adjuvant; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D059351:Organ Sparing Treatments; D018714:Radiotherapy, Adjuvant; D012371:Robotics