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一种修复鼻咽狭窄的新技术:经口机器人手术与鼻内镜手术联合应用以增强可视化和手术精准度

A Novel Technique for Nasopharyngeal Stenosis Repair: Combined Transoral Robotic and Endonasal Approaches for Enhanced Visualization and Surgical Precision.

作者信息

Wagner Russel T, Khalili Sammy, Henning Blake, Mundi Neil S

机构信息

Intent Medical Group, Department of Neurosciences, Northwest Community Hospital, Part of Endeavor Health, Arlington Heights, Illinois, United States.

出版信息

J Neurol Surg Rep. 2025 Jan 27;86(1):e14-e18. doi: 10.1055/a-2466-7414. eCollection 2025 Jan.

DOI:10.1055/a-2466-7414
PMID:39872363
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11772072/
Abstract

Nasopharyngeal stenosis is a challenging condition characterized by a narrowed nasopharynx, leading to nasal congestion, impaired breathing, and recurrent sinus issues. In this report, we present a unique surgical approach that combines the use of both the Da Vinci Xi robot and a 70-degree nasal endoscope in a patient with a type II stenosis of the nasopharynx. The benefits of improved visualization, maneuverability, and precision of this novel combined approach are highlighted. It also highlights the benefit of using mitomycin C in minimizing the risk of re-stenosis. This previously undescribed technique can not only improve patient outcomes, but it also paves the way for future advancements and broader applications in robotically assisted procedures involving the skull base and oropharynx.

摘要

鼻咽狭窄是一种具有挑战性的病症,其特征为鼻咽部狭窄,导致鼻塞、呼吸障碍和反复出现的鼻窦问题。在本报告中,我们介绍了一种独特的手术方法,该方法在一名患有II型鼻咽狭窄的患者中联合使用了达芬奇Xi机器人和70度鼻内镜。强调了这种新型联合方法在改善可视化、可操作性和精确性方面的益处。还强调了使用丝裂霉素C在降低再狭窄风险方面的益处。这种先前未描述的技术不仅可以改善患者预后,还为涉及颅底和口咽的机器人辅助手术的未来进展和更广泛应用铺平了道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/e32e06c390cd/10-1055-a-2466-7414-i24aug0049-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/92a3014fcd7c/10-1055-a-2466-7414-i24aug0049-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/6da31a69698e/10-1055-a-2466-7414-i24aug0049-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/6a89a5b20fca/10-1055-a-2466-7414-i24aug0049-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/b26f282cd276/10-1055-a-2466-7414-i24aug0049-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/e32e06c390cd/10-1055-a-2466-7414-i24aug0049-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/92a3014fcd7c/10-1055-a-2466-7414-i24aug0049-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/6da31a69698e/10-1055-a-2466-7414-i24aug0049-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/6a89a5b20fca/10-1055-a-2466-7414-i24aug0049-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/b26f282cd276/10-1055-a-2466-7414-i24aug0049-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b341/11772072/e32e06c390cd/10-1055-a-2466-7414-i24aug0049-5.jpg

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本文引用的文献

1
The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery.达芬奇Xi系统:对其在机器人结直肠手术中的功能、通用性及潜在作用的综述
Robot Surg. 2017 Jul 28;4:77-85. doi: 10.2147/RSRR.S119317. eCollection 2017.
2
Palatal eversion for the treatment of combined nasopharyngeal stenosis and tonsillar pillars adhesion.腭翻转术治疗鼻咽部狭窄合并扁桃体柱粘连
Int J Pediatr Otorhinolaryngol. 2016 Nov;90:227-230. doi: 10.1016/j.ijporl.2016.09.028. Epub 2016 Sep 23.
3
Complete nasopharyngeal stenosis: presentation of a rare case.
完全性鼻咽狭窄:1例罕见病例报告
Eurasian J Med. 2012 Dec;44(3):185-7. doi: 10.5152/eajm.2012.44.
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Clinical applications of Telerobotic ENT-Head and Neck surgery.远程机器人耳鼻喉头颈外科手术的临床应用。
Int J Surg. 2011;9(4):277-84. doi: 10.1016/j.ijsu.2011.01.008. Epub 2011 Jan 27.
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Current status of robotic assisted pelvic surgery and future developments.机器人辅助骨盆手术的现状与未来发展。
Int J Surg. 2009 Oct;7(5):431-40. doi: 10.1016/j.ijsu.2009.08.008. Epub 2009 Sep 6.
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Early experience of tele-robotic surgery in children.儿童远程机器人手术的早期经验。
Int J Med Robot. 2007 Sep;3(3):199-202. doi: 10.1002/rcs.150.
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Management of nasopharyngeal stenosis after uvulopalatoplasty.悬雍垂腭咽成形术后鼻咽狭窄的处理
Otolaryngol Head Neck Surg. 2000 Dec;123(6):692-5. doi: 10.1067/mhn.2000.110962.