Abstrakt ORL Listopad 2010

“New Trends in Parathyroid Surgery.”

Adler, J. T., R. S. Sippel, et al. (2010).

Current Problems in Surgery47(12): 958-1017.

 

 

           

“To TORS or Not to TORS: But Is That the Question?: Comment on “Transoral Robotic Surgery for Advanced Oropharyngeal Carcinoma”.”

Garden, A. S., M. S. Kies, et al. (2010).

Archives of Otolaryngology–Head and Neck Surgery136(11): 1085-1087.

 

 

           

“Head and neck oncology – 2010, part II.”

Myers, E. N. (2010).

Otolaryngologia Polska64(4): 204-214.

 

Part II this article reviewed the current state of the art in head and neck oncology. These include very important and stimulating new areas of interest including the marked acceptance of chemoradiation in favor of surgery in patients with cancer of the head and neck. The concept of HPV as a cause of cancer of the oropharynx is relatively new and very important in the epidemiology of these tumors. New modalities such as PET CT scanning and robotic surgery are discussed and appear to be very important in management of cancer of the head and neck. Endoscopic endonasal skull base surgery is another new high technology contribution to the field of head and neck surgery as is the use of endoscopic assisted thyroid surgery. These and other new concepts are discussed in this manuscript. © by Polskie Towarzystwo Otorynolaryngologów – Chirurgów Glowy i Szyi.

 

 

 

“Robotic-assisted transoral removal of a submandibular megalith.”

Walvekar, R. R., P. D. Tyler, et al. (2010).

Laryngoscope.

 

The majority of salivary stones are less than 8 mm in size and most frequently occur in the submandibular gland. Traditional management of larger stones involves gland resection. Sialendoscopy combined with an external or a transoral sialolithotomy, also called the combined approach technique, permits stone removal and gland preservation. A 31-year-old male presented to our service with a 20-mm megalith in the left submandibular gland. Here we report the first description of a combined approach using the da Vinci Si Surgical System to facilitate transoral stone removal and salivary duct repair. Laryngoscope, 2010.

 

 

 

“Transoral robotic surgery for advanced oropharyngeal carcinoma.”

Weinstein, G. S., B. W. O’Malley Jr, et al. (2010).

Archives of Otolaryngology – Head and Neck Surgery136(11): 1079-1085.

 

Objectives: To determine the oncologic and functional outcomes in patients undergoing primary transoral robotic surgery followed by adjuvant therapy as indicated with a minimum of 18-month follow-up for advanced oropharyngeal carcinoma. Design: Prospective single-center cohort study. Setting: Academic university health system and tertiary referral center. Patients: Forty-seven adults with newly diagnosed and previously untreated advanced oropharyngeal carcinoma. Intervention: Transoral robotic surgery with staged neck dissection and adjuvant therapy as indicated. Main Outcome Measures: Margin status, recurrence, disease-specific and disease-free survival, gastrostomy tube dependence, and safety and efficacy end points. Results: In the 47 patients enrolled with stages III and IV advanced oropharyngeal carcinoma, mean follow-up was 26.6 months. There was no intraoperative or postoperative mortality. Resection margins were positive in 1 patient (2%). Atlast follow-up, local recurrence was identified in 1 patient (2%), regional recurrence in 2 (4%), and distant recurrence in 4 (9%). Disease-specific survival was 98% (45 of 46 patients) at 1 year and 90% (27 of 30 patients) at 2 years. Based on pathologic risk stratification, 18 of 47 patients (38%) avoided chemotherapy, and 5 patients (11%) did not receive adjuvant radiotherapy and concurrent chemotherapy in their treatment regimen. At minimum follow-up of 1 year, only 1 patient required a gastrostomy tube. Conclusions: This novel transoral robotic surgery treatment regimen offers disease control, survival, and safety commensurate with standard treatments and an unexpected beneficial outcome of gastrostomy dependency rates that are markedly lower than those reported with standard nonsurgical therapies. ©2010 American Medical Association. All rights reserved.