Skip to main content

Anatomic Considerations in Transoral Robotic Surgery

  • Chapter
  • First Online:
Book cover Robotic Surgery of the Head and Neck

Abstract

Classic approaches to the head and neck are well described in the surgical literature. These “external” or “open” approaches correspond to traditional anatomic dissections and are thus very familiar to head and neck surgeons. In contrast, the anatomy of the larynx and pharynx from a transoral robotic (TORS) standpoint must be approached from an “inside-out” perspective. Thorough knowledge of this anatomic perspective is necessary for achieving appropriate oncologic resection as well as avoiding potentially catastrophic complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Steiner W, Ambrosch P. Endoscopic laser surgery of the upper aerodigestive tract: with special emphasis on cancer surgery. New York: Theime Stuttgart; 2000.

    Google Scholar 

  2. Begum S, Cao D, Gillison M, Zahurak M, Westra WH. Tissue distribution of human papillomavirus 16 DNA in patients with tonsillar carcinoma. Clin Cancer Res. 2005;11(16):5694–9.

    Article  CAS  PubMed  Google Scholar 

  3. Janfaza P, Nadol JB, Galla RJ, Fabian RL, Montgomery WW, editors. Surgical anatomy of the head and neck. Philadelphia, PA: Lippincott Williams & Wilkins; 2011.

    Google Scholar 

  4. Ohtsuka K, Tomita H, Murakami G. Anatomy of the tonsillar bed: topographical relationship between the palatine tonsil and the lingual branch of the glossopharyngeal nerve. Acta Otolaryngol Suppl. 2002;546:99–109.

    Article  PubMed  Google Scholar 

  5. Dallan I, Seccia V, Muscatello L, Lenzi R, Castelnuovo P, Bignami M, Montevecchi F, Tschabitscher M, Vicini C. Transoral endoscopic anatomy of the parapharyngeal space: a step-by-step logical approach with surgical considerations. Head Neck. 2011;33(4):557–61.

    Article  PubMed  Google Scholar 

  6. Holsinger FC, McWhorter AJ, Ménard M, Garcia D, Laccourreye O. Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: I. Technique, complications, and functional results. Arch Otolaryngol Head Neck Surg. 2005;131:583–91.

    Article  PubMed  Google Scholar 

  7. Weinstein GS, O’Malley BW, Snyder W, Sherman E, Quon H. Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg. 2007;133:1220–6.

    Article  PubMed  Google Scholar 

  8. Tubbs RS, Loukas M, Dixon J, Cohen-Gadol AA. Compression of the cervical internal carotid artery by the stylopharyngeus muscle: an anatomical study with potential clinical significance. Laboratory investigation. J Neuosurg. 2010;113:881–4.

    Article  Google Scholar 

  9. Wang C, Kundaria S, Fernandez-Miranda J, Duvvuri U. A description of arterial variants in the transoral approach to the parapharyngeal space. Clin Anat. 2014;27(7):1016–22.

    Google Scholar 

  10. Goins MR, Pitovski DZ. Posttonsillectomy taste disturbance: a significant complication. Laryngoscope. 2004;114(7):1206–13.

    Article  PubMed  Google Scholar 

  11. Moore EJ, Janus J, Kasperbauer J. Transoral robotic surgery of the oropharynx: clinical and anatomic considerations. Clin Anat. 2012;25:135–41.

    Article  PubMed  Google Scholar 

  12. Lim CM, Mehta V, Chai R, Pinheiro CN, Rath T, Snyderman C, Duvvuri U. Transoral anatomy of the tonsillar fossa and lateral pharyngeal wall: anatomic dissection with radiographic and clinical correlation. Laryngoscope. 2013;123(12):3021–5.

    Article  PubMed  Google Scholar 

  13. Weinstein GS, O’malley BW. Transoral robotic surgery (TORS). San Diego: Plural; 2012.

    Google Scholar 

  14. Deutsch MD, Kriss VM, Willging JP. Distance between the tonsillar fossa and internal carotid artery in children. Arch Otolaryngol Head Neck Surg. 1995;121(12):1410–2.

    Article  CAS  PubMed  Google Scholar 

  15. Pfeiffer J, Ridder GJ. A clinical classification system for aberrant internal carotid arteries. Laryngoscope. 2008;118(11):1931–6.

    Article  PubMed  Google Scholar 

  16. Ozgur Z, Celik S, Govsa F, Aktug H, Ozgur T. A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance. Eur Arch Otorhinolaryngol. 2007;264(12):1483–9. Epub 19 July 2007.

    Article  PubMed  Google Scholar 

  17. Moore EJ, Ebrahimi A, Price DL, Olsen KD. Retropharyngeal lymph node dissection in oropharyngeal cancer treated with transoral robotic surgery. Laryngoscope. 2013;123:1676–81.

    Article  PubMed  Google Scholar 

  18. Byeon HK, Duvvuri U, Kim WS, Park YM, Hong HJ, Koh YW, Choi EC. Transoral robotic retropharyngeal lymph node dissection with or without lateral oropharyngectomy. J Craniofac Surg. 2013;24(4):1156–61.

    Article  PubMed  Google Scholar 

  19. Hollinshead WH. Anatomy for surgeons: the head and neck. 3rd ed. Philadelphia: Harper and Row Publishers; 1982.

    Google Scholar 

  20. Sanders I, Mu L. A three-dimensional atlas of human tongue muscles. Anat Rec. 2013;296(7):1102–14.

    Article  Google Scholar 

  21. Dallan I, Seccia V, Faggioni L, Castelnuovo P, Montevecchi F, Casani AP, Tschabitscher M, Vicini C. Anatomical landmarks for transoral robotic tongue base surgery: comparison between endoscopic, external and radiological perspectives. Surg Radiol Anat. 2013;35(1):3–10.

    Article  PubMed  Google Scholar 

  22. Lauretano AM, Li KK, Caradonna DS, Khosta RK, Fried MP. Anatomic location of the tongue base neurovascular bundle. Laryngoscope. 1997;107(8):1057–9.

    Article  CAS  PubMed  Google Scholar 

  23. Vaughan CW. Vocal fold exposure in phonosurgery. J Voice. 1993;7(2):189–94.

    Article  CAS  PubMed  Google Scholar 

  24. Joshi VM, Wadhwa V, Mukherji SK. Imaging in laryngeal cancer. Indian J Radiol Imaging. 2012;22(3):209–26.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Reidenbach MM. The paraglottic space and transglottic cancer: anatomical considerations. Clin Anat. 1996;9(4):244–51.

    Article  CAS  PubMed  Google Scholar 

  26. Weinstein GS, O’Malley Jr BW, Snyder W, Hockstein NG. Transoral robotic surgery: supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol. 2007;116(1):19–23.

    Article  PubMed  Google Scholar 

  27. Rudert HH, Werner JA. Endoscopic resections of glottic and supraglottic carcinomas with the CO2 laser. Eur Arch Otorhinolaryngol. 1995;252(3):146–8.

    Article  CAS  PubMed  Google Scholar 

  28. Rusu MC, Nimigean V, Banu MA, Cergan R, Niculescu V. The morphology and topography of the superior laryngeal artery. Surg Radiol Anat. 2007;29(8):653–60.

    Article  CAS  PubMed  Google Scholar 

  29. Goyal N, Yoo F, Setabutr D, Goldenberg D. Surgical anatomy of the supraglottic larynx using the da Vinci robot. Head Neck. 2013;36:1126–31.

    Article  PubMed  Google Scholar 

  30. Souvirón R, Maranillo E, Vázquez T, Patel N, McHanwell S, Cobeta I, Scola B, Sañudo J. Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region. Head Neck. 2013;35:57–60.

    Article  PubMed  Google Scholar 

  31. Liu JL, Liang CY, Xiang T, Wang F, Wang LH, Liu SX, Yang HJ. Aberrant branch of the superior laryngeal artery passing through the thyroid foramen. Clin Anat. 2007;20:256–9.

    Article  PubMed  Google Scholar 

  32. Raikos A, Paraskevas GK. The thyroid foramen: a systematic review and surgical considerations. Clin Anat. 2013;26(6):700–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gregory A. Grillone .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Yarlagadda, B.B., Grillone, G.A. (2015). Anatomic Considerations in Transoral Robotic Surgery. In: Grillone, G., Jalisi, S. (eds) Robotic Surgery of the Head and Neck. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1547-7_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-1547-7_2

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1546-0

  • Online ISBN: 978-1-4939-1547-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics