Management of Laryngoceles by Transoral Robotic Approach

摘要

OBJECTIVES: Laryngoceles are air-filled sacs which communicate with the laryngeal lumen. When filled with mucus or pus, they are called laryngomucoceles and laryngopyoceles, respectively. Transoral robotic surgery (TORS) is a new and remarkable technique that expands its usefullness in otorhinolaryngology. Conventional treatments for laryngoceles were previously performed using external approaches, with aesthetically unfavorable and less function-sparing results. Transoral laser microsurgical approaches for laryngoceles were seldom reported. It is aimed to present authors' clinical experience on laryngocele management with TORS which is a rather new technique. STUDY DESIGN: A retrospective patient serial. METHODS: Patients were evaluated for demographic data, type of lesion, reasons for hospital admittance, complaint duration, and previous surgery. Robotic surgery panel including anesthesia time, duration of surgery, need for tracheotomy, postoperative care, follow-up, and recurrence rates were also summarized. RESULTS: Six men (mean age 51.7 years; range 41-62) with laryngoceles underwent successful TORS. Dyspnea and hoarseness were the main complaints. Two patients had undergone previous laryngeal surgery due to laryngeal cancer, with no recurrence of malignancy at admittance for laryngocele. Three had simple laryngocele, 2 had laryngomucocele, and 1 had laryngopyocele. No laryngoceles recurred and no complication such as dysphonia or prolonged dysphagia occurred. CONCLUSION: Transoral robotic surgery was found superior in safety, technical feasibility and curative effectiveness, when compared with classical methods, especially due to absence of skin incisions. Surgical modalities for laryngocele excision should be directed toward a curative target including cosmetic and functional success, technical achievability, and surgically curative methods. Transoral robotic surgery provided all these features.