Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.
Department of Emergency, Burn Center, Bufalini Hospital, Azienda USL della Romagna, Cesena, Italy.
Acta Otorhinolaryngol Ital. 2018 Dec;38(6):569-574. doi: 10.14639/0392-100X-1473.
Transoral robotic surgery (TORS) is a fascinating new technique that has been shown to be a safe and feasible treatment for selected oropharyngeal cancers. Furthermore, TORS might offer some advantages in selected locoregionally advanced cancers. Thus, the patient selection is the keypoint for the useful application of TORS. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons. The paradigm for oropharyngeal reconstruction has undergone changes paralleling reflecting the overall change in the trend of the treatment alternatives over the last few decades. Flap choice and harvesting should be tailored to obtain significant advantages both in functional terms and for easy insetting. In this review, we analyse the strengths and weaknesses of the various flaps used in TORS framework with particular regards on our preliminary experience.
经口机器人手术（TORS）是一种令人着迷的新技术，已被证明是一种安全可行的治疗选择，适用于特定的口咽癌。此外，TORS 可能在某些局部晚期癌症中具有一些优势。因此，患者选择是 TORS 有效应用的关键。然而，由于需要恢复软腭功能和吞咽功能，大型口咽缺损的重建极具挑战性。此外，由于没有下颌骨劈开，增加了重建外科医生所面临的困难。口咽重建的范例随着过去几十年治疗选择趋势的整体变化而发生变化。皮瓣的选择和采集应量身定制，以在功能和易于插入方面获得显著优势。在这篇综述中，我们分析了在 TORS 框架中使用的各种皮瓣的优缺点，并特别提到了我们的初步经验。
