Henry Laura E, Haugen Thorsen W, Rassekh Christopher H, Adappa Nithin D, Weinstein Gregory S, O'Malley Bert W
University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Head Neck. 2019 Aug;41(8):E133-E140. doi: 10.1002/hed.25747. Epub 2019 Apr 10.
In this paper, we present three cases where a novel transoral robotic surgery (TORS) approach was used to resect clival chordomas extending into the nasopharynx to demonstrate progress in the evolution of robotic surgery of the head and neck.
The first patient had a history of metastatic chordoma resection and presented with trismus and dysphagia; the second and third patients had first presentation with nasal congestion and facial numbness, respectively. All patients underwent a novel transpalatal-TORS resection.
Total resection was achieved in the first patient and near-total resections were achieved in the second and third patients. All patients had minimal postoperative morbidity and no patients experienced significant adverse events.
Clival chordomas are rare, potentially dangerous lesions with a high rate of recurrence. The novel transpalatal-TORS approach to these tumors presented in this series represents advancement in the realm of minimally invasive surgery of the head and neck. This approach offers patients total or near-total control of these lesions with minimal intraoperative and postoperative side effects.
在本文中，我们展示了三例采用新型经口机器人手术（TORS）方法切除延伸至鼻咽部的斜坡脊索瘤的病例，以证明头颈机器人手术的进展。
首例患者有转移性脊索瘤切除病史，表现为牙关紧闭和吞咽困难；第二例和第三例患者分别首次表现为鼻塞和面部麻木。所有患者均接受了新型经腭TORS切除术。
首例患者实现了全切除，第二例和第三例患者实现了近全切除。所有患者术后发病率极低，且无患者发生重大不良事件。
斜坡脊索瘤是罕见的、具有潜在危险性且复发率高的病变。本系列中针对这些肿瘤的新型经腭TORS方法代表了头颈微创手术领域的进展。该方法能使患者在术中及术后副作用最小的情况下，对这些病变实现完全或近乎完全的控制。
