title: Determination of biometric measures to evaluate patient suitability for transoral robotic surgery.
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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Asit
authors.initials: A
authors.lastname: Arora
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Jalpa
authors.initials: J
authors.lastname: Kotecha
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Amish
authors.initials: A
authors.lastname: Acharya
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Garas
authors.affiliation: Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.affiliation: Human Anatomy Unit, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital Campus, London, United Kingdom.
authors.forename: D Ceri
authors.initials: DC
authors.lastname: Davies
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Tolley
mesh_terms: D000369:Aged, 80 and over; D000704:Analysis of Variance; D056667:Biometric Identification; D002102:Cadaver; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D018579:Patient Selection; D065287:Robotic Surgical Procedures / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000601:surgery*
keywords: anthropometry; cadaver; da Vinci robotic system; patient selection; transoral exposure