1
|
Li Y, Inamochi Y, Wang Z, Fueki K. Clinical application of robots in dentistry: A scoping review. J Prosthodont Res 2024; 68:193-205. [PMID: 37302842 DOI: 10.2186/jpr.jpr_d_23_00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The surge in digitalization and artificial intelligence has led to the wide application of robots in various fields, but their application in dentistry started relatively late. This scoping review aimed to comprehensively explore and map the current status of the clinical application of robots in dentistry. STUDY SELECTION An iterative approach was used to gather as much evidence as possible from four online databases, including PubMed, the China National Knowledge Infrastructure, the Japan Science and Technology Information Aggregator, Electronic, and the Institute of Electrical and Electronics Engineers, from January 1980 to December 2022. RESULTS A total of 113 eligible articles were selected from the search results, and it was found that most of the robots were developed and applied in the United States (n = 56; 50%). Robots were clinically applied in oral and maxillofacial surgery, oral implantology, prosthodontics, orthodontics, endodontics, and oral medicine. The development of robots in oral and maxillofacial surgery and oral implantology is relatively fast and comprehensive. About 51% (n = 58) of the systems had reached clinical application, while 49% (n = 55) were at the pre-clinical stage. Most of these are hard robots (90%; n = 103), and their invention and development were mainly focused on university research groups with long research periods and diverse components. CONCLUSIONS There are still limitations and gaps between research and application in dental robots. While robotics is threatening to replace clinical decision-making, combining it with dentistry to gain maximum benefit remains a challenge for the future.
Collapse
Affiliation(s)
- Yajie Li
- Department of Masticatory Function and Health Science, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuka Inamochi
- Department of Masticatory Function and Health Science, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Zuo Wang
- School & Hospital of Stomatology, Tongji University, Shanghai, China
| | - Kenji Fueki
- Department of Masticatory Function and Health Science, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| |
Collapse
|
2
|
Motta G, Testa D, Donadio A, Ricciardiello F, Cavaliere M, Massimilla EA, Motta G. Transoral Approach to Parapharyngeal Space Tumours: Preliminary Reports from a Single-Centre Retrospective Analysis. Curr Oncol 2023; 30:3927-3939. [PMID: 37185410 PMCID: PMC10136736 DOI: 10.3390/curroncol30040297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/20/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Purpose: The aim of this study is to identify certain parapharyngeal space tumours with specific characteristics that can be treated successfully through an endoscopically assisted transoral approach (EATA). Methods: Nine patients with PPS tumours underwent surgery through an EATA between 2003 and 2021. All patients underwent clinical examination and fibrolaryngoscopy. Preoperative CT and/or MRI was performed on all patients. Results: All the patients were successfully treated through an endoscopically assisted transoral approach. Histological examination revealed five pleomorphic adenomas, two schwannomas, one ectopic thyroid gland and one lipoma. The only long-term sequelae observed was Horner syndrome in the two schwannomas arising from the carotid space. The mean hospitalisation time was 2.6 days, while the mean follow-up time was of 9.7 years. Conclusions: An endoscopically assisted transoral approach (EATA) is a valid technique for treating benign capsulated tumours of the true PPS and some benign capsulated tumours of the superomedial aspect of the carotid space.
Collapse
Affiliation(s)
- Giovanni Motta
- ENT Unit-Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Domenico Testa
- ENT Unit-Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Anna Donadio
- ENT Unit-Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | | | - Michele Cavaliere
- Otorhinolaryngology-Head and Neck Surgery Unit, Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80138 Naples, Italy
| | - Eva Aurora Massimilla
- ENT Unit-Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Gaetano Motta
- ENT Unit-Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| |
Collapse
|
3
|
Riva G, Lorenzi A, Borello A, Albera A, Canale A, Pecorari G. Transoral Approach to Parotid Tumors: A Review of the Literature. Curr Oncol 2022; 29:9416-9427. [PMID: 36547154 PMCID: PMC9776422 DOI: 10.3390/curroncol29120740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Different surgical techniques have been proposed for parapharyngeal space tumors, including transcervical, transparotid, trans-mandibular, infratemporal, and transoral. The choice of the correct approach depends on the size, localization and nature of the tumor. The transoral approach can be used for benign prestyloid masses, such as tumors of the deep lobe of the parotid gland. It guarantees a short hospitalization without skin scars. The narrowed access represents the main limitation of this technique. This review will summarize and analyze the current knowledge about the transoral approach to parotid lesions. Thirty-seven studies were included in a qualitative and quantitative synthesis. The novelty of this review is the quantitative analyses of the clinical data reported in the included studies.
Collapse
|
4
|
Liu J, Liu Q, Sun XC, Yu HM, Wang DH. Endoscopic transoral approach to the parapharyngeal space: technical nuances and preliminary results. J Laryngol Otol 2022:1-7. [PMID: 35791870 DOI: 10.1017/s0022215122001621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Surgical management is the mainstay of treatment for tumours in the parapharyngeal space. This study aimed to evaluate the indications, limits and technical nuances of the endoscopic transoral approach. METHOD Thirteen patients with parapharyngeal space tumours that were treated between May 2017 and November 2020 were included in this retrospective study. RESULTS All patients underwent surgery for complete oncological resection except one patient who received treatment for diagnostic purposes. No major complications were reported, with excellent control of the vital structures of the parapharyngeal space. CONCLUSION The endoscopic transoral approach to the parapharyngeal space is a promising alternative approach for selected parapharyngeal space tumours with satisfactory outcomes.
Collapse
Affiliation(s)
- J Liu
- Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, PR China
| | - Q Liu
- Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, PR China
| | - X-C Sun
- Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, PR China
| | - H-M Yu
- Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, PR China
| | - D-H Wang
- Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, PR China
| |
Collapse
|
5
|
Lim JY, Park YM, Kang MS, Kim DH, Choi EC, Kim SH, Koh YW. Comparison of Surgical Outcomes of Robotic and Conventional Approaches in Patients with Pre- and Poststyloid Parapharyngeal Space Tumors. Ann Surg Oncol 2020; 27:4535-4543. [PMID: 32474818 DOI: 10.1245/s10434-020-08536-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Benefits and drawbacks of robotic surgical approaches for parapharyngeal space (PPS) tumors remain undetermined. The purpose of this study is to compare surgical outcomes of PPS tumor patients who underwent robotic surgery with those of patients who received conventional surgical treatment. PATIENTS AND METHODS We retrospectively analyzed clinicopathologic data from 136 patients who underwent surgical removal of PPS tumors via conventional or robotic approaches. RESULTS We identified PPS tumors in pre- and poststyloid regions in 87 (64%) and 49 (36%) patients, respectively. There were 48 (35.3%) pleomorphic adenomas, 36 (26.5%) schwannomas, and 24 (17.6%) paragangliomas. Conventional surgical techniques were performed in 83 patients, and robotic surgical approaches were administered to 53 patients. Transcervical-parotid and transcervical approaches were most commonly performed in conventional surgery, while transoral and retroauricular approaches were the preferred surgical methods in robotic surgery for pre- and poststyloid PPS tumors, respectively. Robotic surgery resulted in less estimated blood loss during poststyloid PPS tumor surgery. Postoperative cranial nerve complications were noted in 36 of 83 cases (43.4%) in the conventional surgery group and in 17 of 53 cases (32.1%) in the robotic surgery group. Intraoperative tumor spillage of pleomorphic adenoma showed no significant differences between the two groups (13.6% in conventional vs. 15.4% in robotic surgery). The mean follow-up time was 4.9 ± 3.4 years, and recurrences were observed in two patients during follow-up without a significant difference between the two groups (4.5% in conventional vs. 3.8% in robotic surgery). CONCLUSIONS Robotic surgery in PPS tumors is feasible through transoral, retroauricular, or combined approaches and provides treatment outcomes comparable to those of conventional open surgery.
Collapse
Affiliation(s)
- Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Da Hee Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
6
|
De Virgilio A, Costantino A, Mercante G, Di Maio P, Iocca O, Spriano G. Trans-oral robotic surgery in the management of parapharyngeal space tumors: A systematic review. Oral Oncol 2020; 103:104581. [PMID: 32058293 DOI: 10.1016/j.oraloncology.2020.104581] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/06/2020] [Accepted: 01/20/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To perform a systematic review of studies evaluating Trans-oral Robotic Surgery (TORS) in the treatment of parapharyngeal space (PPS) tumors. METHODS A comprehensive electronic search was performed in PubMed/MEDLINE, Cochrane Library, and Google Scholar databases for appropriate published studies. The last search was conducted on November 9, 2019. RESULTS Twenty-two studies were included for the systematic review which analyzed a total of 113 patients (median age 53.5, IQR 41.5-58.1). The most common PPS tumor treated with TORS was the pleomorphic adenoma (n = 66; 58.4%). All tumors were successfully resected. The median tumor size was 4.8 cm (n = 73; IQR 3.8-5.4). Combined transcervical (TORS-TC) and transparotid (TORS-TP) approaches were used in 13 (11.5%) and 5 (4.4%) patients, respectively. Capsule disruption was noted in 11 cases (14.5%), while tumor fragmentation was observed in 7 patients (10.3%). The median time of hospitalization was 3 days (n = 79; IQR 2-4.1). Oral diet was possible from the day after surgery in the majority of patients (n = 34, 68%). The most common complication was dysphagia (n = 5, 4.5%). CONCLUSIONS This systematic review confirms the safety and feasibility of TORS in the treatment of PPS lesions. Given the low quality of included studies, further evidence is needed in order to establish clinical guidelines.
Collapse
Affiliation(s)
- Armando De Virgilio
- Humanitas University, Via Rita Levi Montalcini, 4, 20090 Pieve Emanuele (MI), Italy; Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano (MI), Italy.
| | - Andrea Costantino
- Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano (MI), Italy
| | - Giuseppe Mercante
- Humanitas University, Via Rita Levi Montalcini, 4, 20090 Pieve Emanuele (MI), Italy; Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano (MI), Italy
| | - Pasquale Di Maio
- Department of Otolaryngology-Head and Neck Surgery, Giovanni Borea Civil Hospital, Sanremo, Italy
| | - Oreste Iocca
- Humanitas University, Via Rita Levi Montalcini, 4, 20090 Pieve Emanuele (MI), Italy
| | - Giuseppe Spriano
- Humanitas University, Via Rita Levi Montalcini, 4, 20090 Pieve Emanuele (MI), Italy; Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano (MI), Italy
| |
Collapse
|
7
|
López F, Suárez C, Vander Poorten V, Mäkitie A, Nixon IJ, Strojan P, Hanna EY, Rodrigo JP, de Bree R, Quer M, Takes RP, Bradford CR, Shaha AR, Sanabria A, Rinaldo A, Ferlito A. Contemporary management of primary parapharyngeal space tumors. Head Neck 2018; 41:522-535. [PMID: 30549361 DOI: 10.1002/hed.25439] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 06/19/2018] [Accepted: 07/06/2018] [Indexed: 01/28/2023] Open
Abstract
The parapharyngeal space is a complex anatomical area. Primary parapharyngeal tumors are rare tumors and 80% of them are benign. A variety of tumor types can develop in this location; most common are salivary gland neoplasm and neurogenic tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques, surgery, and radiotherapy. Most tumors can be removed with a low rate of complications and recurrence. The transcervical approach is the most frequently used. In some cases, minimally invasive approaches may be used alone or in combination with a limited transcervical route, allowing large tumors to be removed by reducing morbidity of expanded approaches. An adequate knowledge of the anatomy and a careful surgical plan is essential to tailor management according to the patient and the tumor. The purpose of the present review was to update current aspects of knowledge related to this more challenging area of tumor occurrence.
Collapse
Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, Oviedo, Spain
| | - Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, Oviedo, Spain
| | - Vincent Vander Poorten
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Antti Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Iain J Nixon
- NHS Lothian, University of Edinburgh, Edinburgh, United Kingdom
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Juan Pablo Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, Oviedo, Spain
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Miquel Quer
- Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carol R Bradford
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia, Clínica Vida/Instituto de Cancerología Las Américas, Medellín, Colombia
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
| |
Collapse
|
8
|
Chen Z, Chen YL, Yu Q, Zhou SH, Bao YY, Shang DS, Ruan LX. Excision of tumors in the parapharyngeal space using an endoscopically assisted transoral approach: a case series and literature review. J Int Med Res 2018; 47:1103-1113. [PMID: 30526171 PMCID: PMC6421391 DOI: 10.1177/0300060518816190] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) provides important information regarding tumors in the parapharyngeal space (PPS), revealing their origin, whether they are benign or malignant, and their relationships with surrounding structures. METHODS Twelve tumors in the PPS were completely excised using an endoscopically assisted transoral approach (EATA). The MRI features were analyzed. RESULTS Ten pleomorphic adenomas confirmed on postoperative pathological examination had the parotid pedicle sign. A fat space between the tumor and parotid gland may distinguish such a tumor from a tumor arising from a minor salivary gland in the prestyloid space and a tumor arising from the deep lobe of the parotid gland. Both the jugular vein and carotid artery were displaced posteriorly in all 10 cases of pleomorphic adenomas. The principal features of the two schwannomas confirmed on postoperative pathological examination were separation of the internal carotid artery and internal jugular vein and anteromedial displacement of the internal carotid artery, suggesting that the tumors originated in the poststyloid space. In this review, 95 tumors were excised by the EATA in the English-language literature. CONCLUSIONS MRI renders differential diagnosis possible. PPS tumors may be completely excised via an EATA guided by tumor features evident on preoperative MRI.
Collapse
Affiliation(s)
- Zhe Chen
- 1 Department of Otolaryngology, Hangzhou City, Zhejiang Province, China
| | - Ya-Lian Chen
- 1 Department of Otolaryngology, Hangzhou City, Zhejiang Province, China
| | - Qi Yu
- 1 Department of Otolaryngology, Hangzhou City, Zhejiang Province, China
| | - Shui-Hong Zhou
- 1 Department of Otolaryngology, Hangzhou City, Zhejiang Province, China
| | - Yang-Yang Bao
- 1 Department of Otolaryngology, Hangzhou City, Zhejiang Province, China
| | - De-Sheng Shang
- 2 Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ling-Xiang Ruan
- 2 Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| |
Collapse
|
9
|
Duek I, Sviri GE, Billan S, Gil Z. Minimally Invasive Surgery for Resection of Parapharyngeal Space Tumors. J Neurol Surg B Skull Base 2017; 79:250-256. [PMID: 29765822 DOI: 10.1055/s-0037-1607315] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 09/10/2017] [Indexed: 10/18/2022] Open
Abstract
Background Surgical removal of parapharyngeal space tumors (PPST) poses challenges due to the complex anatomy of the region. PPSTs are routinely resected by a transcervical approach using blind finger dissection. Large PPSTs or those located high at the skull base, often require transmandibular or infratemporal fossa approaches, associated with considerable morbidity. Objective Here, we describe an approach for PPST removal that comprises transcervical endoscopic, with or without transoral robotic technique. Materials and Methods We retrospectively studied the demographic, clinical, surgical, and outcome data of 11 consecutive patients who underwent PPST excision between June 2013 and July 2017 at our center. Patients either underwent a transcervical endoscopic procedure ( n = 4), a transoral robotic procedure ( n = 2) or a combination of the two procedures ( n = 5). Results Complete tumor excision was achieved in all cases, with no intra-, peri-, or postoperative complications. Final histopathologic findings demonstrated pleomorphic adenoma for seven patients, cavernous hemangioma for one patient, and malignant tumors for three patients. The average tumor size was 44.22 ± 31.9 cm 3 (range: 7.5-111 cm 3 ). At follow-up (range: 3-42 months), there was no evidence of recurrence. Conclusions The approach described provides improved visualization and safe vascular control with minimum tumor stress, preventing the need for blind finger dissection, and allowing complete tumor removal while minimizing tumor spillage, nerve injury, and blood loss, maintaining excellent cosmetic and functional results. This approach could be utilized for the removal of large benign PPST, or small PPST located high.
Collapse
Affiliation(s)
- Irit Duek
- The Head and Neck Center, Rambam Health Care Campus, Haifa, Israel.,Department of Otolaryngology Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Gill E Sviri
- The Head and Neck Center, Rambam Health Care Campus, Haifa, Israel.,Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel
| | - Salem Billan
- The Head and Neck Center, Rambam Health Care Campus, Haifa, Israel.,Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - Ziv Gil
- The Head and Neck Center, Rambam Health Care Campus, Haifa, Israel.,Department of Otolaryngology Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel
| |
Collapse
|
10
|
Liu HH, Li LJ, Shi B, Xu CW, Luo E. Robotic surgical systems in maxillofacial surgery: a review. Int J Oral Sci 2017; 9:63-73. [PMID: 28660906 PMCID: PMC5518975 DOI: 10.1038/ijos.2017.24] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2017] [Indexed: 12/26/2022] Open
Abstract
Throughout the twenty-first century, robotic surgery has been used in multiple oral surgical procedures for the treatment of head and neck tumors and non-malignant diseases. With the assistance of robotic surgical systems, maxillofacial surgery is performed with less blood loss, fewer complications, shorter hospitalization and better cosmetic results than standard open surgery. However, the application of robotic surgery techniques to the treatment of head and neck diseases remains in an experimental stage, and the long-lasting effects on surgical morbidity, oncologic control and quality of life are yet to be established. More well-designed studies are needed before this approach can be recommended as a standard treatment paradigm. Nonetheless, robotic surgical systems will inevitably be extended to maxillofacial surgery. This article reviews the current clinical applications of robotic surgery in the head and neck region and highlights the benefits and limitations of current robotic surgical systems.
Collapse
Affiliation(s)
- Hang-Hang Liu
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - Long-Jiang Li
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - Bin Shi
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - Chun-Wei Xu
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - En Luo
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| |
Collapse
|
11
|
True Parapharyngeal Space Tumors: Case Series from a Teaching Oncology Center. Indian J Otolaryngol Head Neck Surg 2017; 69:225-229. [PMID: 28607895 DOI: 10.1007/s12070-017-1099-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 01/31/2017] [Indexed: 10/20/2022] Open
Abstract
The Parapharyngeal Space (PPS) tumors are rare tumors accounting for 0.5% of the tumors in head and neck region. A retrospective study conducted at Department of Surgical oncology, Vydehi institute of Medical Sciences & Research center, Bengaluru, between 2010 and 2015 identified nine cases treated for PPS tumors. Patients are diagnosed on the basis of clinical examination fine needle aspiration cytology and imaging and considered for excision by one of the varied surgical approaches {transoral(1), transcervical(4), transparotid(0), transcervical-transparotid(1), transmandibular(3) or intratemporal(0) approach}. The choice of approach is defined by the size of the tumor, suspicion of malignancy and the position of the tumor with regard to the superior extent and proximity to the skull base as well as its relation with neurovascular bundle.
Collapse
|
12
|
Endoscopic-assisted transoral-transpharyngeal approach to parapharyngeal space and infratemporal fossa: focus on feasibility and lessons learned. Eur Arch Otorhinolaryngol 2016; 273:3965-3972. [DOI: 10.1007/s00405-016-4074-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
|
13
|
Boyce BJ, Curry JM, Luginbuhl A, Cognetti DM. Transoral robotic approach to parapharyngeal space tumors: Case series and technical limitations. Laryngoscope 2016; 126:1776-82. [PMID: 27010862 DOI: 10.1002/lary.25929] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 01/04/2016] [Accepted: 01/25/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS The transoral robotic approach to parapharyngeal space (PPS) tumors is a new technique with limited data available on its feasibility, safety, and efficacy. We analyzed our experience with transoral robotic excisions of PPS tumors to evaluate the safety and efficacy of this technique. STUDY DESIGN Retrospective chart analysis at tertiary academic medical center. From July 2010 to June 2014, 17 patients who had transoral robotic excision of PPS tumors were included in the study. Our cohort had an average age of 61.6 years and was 52.9% male. RESULTS All patients had successful removal of their PPS tumors, and the average size of the tumors was 27.3 cm(3) (range 2-80 cm(3) ). Two cases (11.7%) required a cervical incision to assist with tumor removal. The average total operative time was 140.5 minutes. Two PPS PAs had focal areas of capsule rupture and one was fragmented. The average length of stay was 1.8 days (range 1-7 days), and all patients were discharged on an oral diet. Three patients experienced complications. There was no clinical or radiographic evidence of recurrence. CONCLUSION This is the largest single-institution case series of transoral robotic approaches to PPS tumors. We demonstrate that this approach is feasible and safe but also note limitations of the robotic approaches for tumors on the far lateral and superior areas of the PPS, which required transcervical assistance. There were no patients who demonstrated recurrent tumor either radiographically or clinically. LEVEL OF EVIDENCE 4. Laryngoscope, 126:1776-1782, 2016.
Collapse
Affiliation(s)
- Brian J Boyce
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| | - Joseph M Curry
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| | - Adam Luginbuhl
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| | - David M Cognetti
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| |
Collapse
|
14
|
Recent advances in surgical management of parapharyngeal space tumors. Curr Opin Otolaryngol Head Neck Surg 2015; 23:83-90. [DOI: 10.1097/moo.0000000000000134] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Guo YX, Sun ZP, Liu XJ, Bhandari K, Guo CB. Surgical safety distances in the infratemporal fossa: three-dimensional measurement study. Int J Oral Maxillofac Surg 2014; 44:555-61. [PMID: 25441861 DOI: 10.1016/j.ijom.2014.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 04/29/2014] [Accepted: 06/09/2014] [Indexed: 10/24/2022]
Abstract
The wedge-shaped infratemporal fossa is a constricted space and has long been a surgical challenge, mainly due to difficulties in access. Three-dimensional (3D) reconstruction of the skull, internal carotid artery (ICA), and internal jugular vein (IJV) was carried out using enhanced computed tomography (CT) data, to measure the safety distances in relation to infratemporal fossa surgery. Fifty enhanced CT datasets were selected to reconstruct 3D images by segmentation technique. The anatomical routes of the ICA, IJV, and the styloid process (SP) were observed. The following were measured: SP length, height of the pterygoid plates (PP height), distances from the pterygoid process (antero-inferior and anterosuperior border) to the leading edge of the ICA (PP-ICA (inferior), PP-ICA (superior)), and distance between the most prominent point of the zygomatic arch and the medial pterygoid plate (Zyg-MPP). The mean measurements of SP length, PP height, and the distances PP-ICA (inferior), PP-ICA (superior), and Zyg-MPP were 30.64 mm, 26.61 mm, 31.16 mm, 34.37 mm, and 51.37 mm, respectively. No significant differences were observed by age group, except the distance of PP-ICA (inferior) on the left side. In centres without intraoperative navigation facilities, proper knowledge of the anatomy, particularly of bony landmarks and the safe distances to nearby neurovascular structures, can provide useful information to ensure safe operations.
Collapse
Affiliation(s)
- Y X Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Z P Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - X J Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - K Bhandari
- Chitwan Medical College, Bharatpur, Chitwan, Nepal
| | - C B Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
| |
Collapse
|
16
|
Sheahan P. Transcervical approach for removal of benign parapharyngeal space tumors. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.otot.2014.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
17
|
Transoral robotic surgery in retrostyloid parapharyngeal space schwannomas. Case Rep Otolaryngol 2014; 2014:296025. [PMID: 25202464 PMCID: PMC4151484 DOI: 10.1155/2014/296025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/14/2014] [Indexed: 11/17/2022] Open
Abstract
Parapharyngeal space (PPS) tumors are very rare, representing about 0.5% of head and neck neoplasms. An external surgical approach is mainly used. Several recent papers show how transoral robotic surgery (TORS) excision could be a prospective tool to remove mainly benign lesions in PPS; no cases of neurogenic tumors from the retrostyloid space treated with TORS have been reported. We present two cases which underwent TORS for schwannomas from the retrostyloid compartment of the parapharyngeal space. Clinical diagnosis of schwannoma was performed by magnetic resonance imaging (MRI). In the first case a 6 cm neurogenic tumor arose from the vagus nerve and in the second case a 5 cm mass from the sympathetic chain was observed. Both cases were treated successfully by the TORS approach using a new "J"-shaped incision through the mucosa and superior pharyngeal constrictor muscle. Left vocal cord palsy and the Claude Bernard Horner syndrome, respectively, were observed as expected postsurgical sequelae. In case 1 the first bite syndrome developed after three months, while no complications were observed in case 2. Both patients regained a normal swallowing function. TORS seems to be a feasible mini-invasive procedure for benign PPS masses including masses in the poststyloid space.
Collapse
|
18
|
Chan JYK, Tsang RK, Eisele DW, Richmon JD. Transoral robotic surgery of the parapharyngeal space: A case series and systematic review. Head Neck 2014; 37:293-8. [DOI: 10.1002/hed.23557] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2013] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jason Y. K. Chan
- Department of Otolaryngology - Head and Neck Surgery; Johns Hopkins Medical Institutions; Baltimore Maryland
| | - Raymond K. Tsang
- Division of Otolaryngology - Head and Neck Surgery; Department of Surgery; University of Hong Kong, Queen Mary Hospital; Hong Kong SAR China
| | - David W. Eisele
- Department of Otolaryngology - Head and Neck Surgery; Johns Hopkins Medical Institutions; Baltimore Maryland
| | - Jeremy D. Richmon
- Department of Otolaryngology - Head and Neck Surgery; Johns Hopkins Medical Institutions; Baltimore Maryland
| |
Collapse
|