Determination of biometric measures to evaluate patient suitability for transoral robotic surgery

Head Neck. 2015 Sep;37(9):1254-60. doi: 10.1002/hed.23739. Epub 2014 Oct 29.

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.

Keywords: anthropometry; cadaver; da Vinci robotic system; patient selection; transoral exposure.

MeSH terms

  • Aged, 80 and over
  • Analysis of Variance
  • Biometric Identification
  • Cadaver
  • Feasibility Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Natural Orifice Endoscopic Surgery / methods*
  • Oropharyngeal Neoplasms / surgery*
  • Patient Selection
  • Robotic Surgical Procedures / methods*
  • Sleep Apnea, Obstructive / surgery*