Determination of biometric measures to evaluate patient suitability for transoral robotic surgery
Corresponding Author
Asit Arora MRCS, DOHNS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Corresponding author: A. Arora, Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, United Kingdom W2 1NY. E-mail: [email protected]Search for more papers by this authorJalpa Kotecha MBBS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorAmish Acharya MBBS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorGeorge Garas MRCS, DOHNS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorAra Darzi KBE, MD, FRCS
Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom
Search for more papers by this authorD. Ceri Davies PhD
Human Anatomy Unit, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital Campus, London, United Kingdom
Search for more papers by this authorNeil Tolley MD, FRCS, DLO
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorCorresponding Author
Asit Arora MRCS, DOHNS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Corresponding author: A. Arora, Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, United Kingdom W2 1NY. E-mail: [email protected]Search for more papers by this authorJalpa Kotecha MBBS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorAmish Acharya MBBS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorGeorge Garas MRCS, DOHNS
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorAra Darzi KBE, MD, FRCS
Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom
Search for more papers by this authorD. Ceri Davies PhD
Human Anatomy Unit, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital Campus, London, United Kingdom
Search for more papers by this authorNeil Tolley MD, FRCS, DLO
Department of Otorhinolaryngology and Head and Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Search for more papers by this authorThe results contained in this article were presented at the American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting & OTO EXPO; September 9–12, 2012; Washington, DC.
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.
Conclusion
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. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1254–1260, 2015
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