Transoral Robotic Surgery Total Laryngectomy: Evaluation of Functional and Survival Outcomes in a Retrospective Case Series at a Single Institution

Abstract

BACKGROUND: Transoral robotic surgery total laryngectomy (TORS-TL) is a minimally invasive endoscopic surgical approach which can theoretically minimise the morbidity of large external incisions and limit dissection of tissue planes so as to reduce the risk of pharyngocutaneous fistulae related to poor tissue healing secondary to radiation soft tissue injury or malnutrition. The purpose of this paper was to report our experience with this uncommon surgical approach. METHODS: A retrospective chart review was conducted at a single institution to evaluate the functional and survival outcomes of a series of patients who underwent TORS-TL. RESULTS: TORS-TL was performed on 5 patients. Two patients had total laryngectomy for recurrent aspiration secondary to neurological disorders, 1 patient had an adenoid cystic carcinoma of the subglottis, 1 patient had a low-grade subglottic chondrosarcoma, and 1 patient had a T2 local recurrence of glottic squamous cell carcinoma following treatment with primary chemoradiotherapy. CONCLUSIONS: TORS-TL is a feasible and safe treatment option with possible advantages for carefully selected patients in experienced hands.