Combined transoral transnasal robotic-assisted nasopharyngectomy: a cadaveric feasibility study

Eur Arch Otorhinolaryngol. 2012 Jan;269(1):235-9. doi: 10.1007/s00405-011-1550-x. Epub 2011 Mar 18.


Surgical management of the nasopharynx is complex. Both traditional and endoscopic transnasal techniques are demanding. Purely transoral robotic nasopharyngectomy has been described but it needs a palatal splitting and is performed with an inferior to superior perspective with a difficult vision of the upper regions. The aim of this study is to investigate a new robotic surgical setting, which is able to overcome the actual limits. The DaVinci Surgical System was used in two cadavers. Dissection was carried out through a combined transnasal-transoral approach and a purely transoral procedure. A complete nasopharyngectomy was performed with both settings. Working and setting times are comparable. The combined approach avoids palatal spitting and permits a more panoramic view of the surgical field with an easier dissection of the upper areas. A robotic palatal sparing nasopharyngectomy is feasible. The combined transnasal-transoral setting seems to offer significant advantages with respect to traditionally purely transoral procedures.

MeSH terms

  • Cadaver
  • Feasibility Studies
  • Humans
  • Nasopharynx / surgery*
  • Otorhinolaryngologic Surgical Procedures / methods
  • Robotics / methods*