Treatment of tongue base masses in children by transoral robotic surgery

Eur Arch Otorhinolaryngol. 2017 Sep;274(9):3457-3463. doi: 10.1007/s00405-017-4646-0. Epub 2017 Jun 17.

Abstract

The feasibility and effectiveness of transoral robotic surgery (TORS) in children with tongue base masses (TBMs) were evaluated. Eight pediatric patients who were treated with TORS for TBMs between January 2010 and January 2016 at a tertiary hospital included in the study. All pathologies were congenital lesions: four were lingual thyroglossal ductus cysts (LTGDCs), one was a minor salivary gland tumor, one was a vallecular cyst, one was a bronchogenic cyst, and one was an ectopic thyroid tissue. TORS was performed successfully in all cases. The mean robotic set-up and exposure time was 13.0 ± 2.1 min (range 10-16 min) and the mean robotic surgery time was 8.8 ± 6.9 min (range 4-25 min). Estimated blood loss was lower than 5 ml for one patient and lower than 50 ml for another one. The remaining patients' estimated blood loss was lower than 10 ml. No patient required tracheostomy intra- or post-operatively. Only one minor complication occurred on day 10 after surgery (minor bleeding), which was resolved without intervention. No major complications or recurrence were observed. Better visualization and small, flexible arms allow surgeons to treat TBM faster and easily using TORS. This leads to decreased morbidity compared to open and transoral endoscopic/microscopic surgical methods. In the future, we believe that TORS may become the gold standard method for the treatment of pediatric TBM with continued development of robotic technology.

Keywords: Pediatric; Tongue base; Transoral robotic surgery.

MeSH terms

  • Child
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Mouth
  • Natural Orifice Endoscopic Surgery / methods*
  • Neoplasm Staging
  • Robotic Surgical Procedures / methods*
  • Tongue / pathology
  • Tongue / surgery
  • Tongue Neoplasms / diagnosis
  • Tongue Neoplasms / surgery*
  • Treatment Outcome