Hemostatic Options for Transoral Robotic Surgery of the Pharynx and Base of Tongue.

Surgery with transoral robotic surgery (TORS) offers significant advantages compared with traditional open surgical approaches and potentially minimizes the long-term side effects of organ preservation therapy with chemoradiation. Angled telescopes and wristed instruments allow visualization and access to areas of the pharynx that are difficult to reach with line-of-sight instrumentation. Although the application of TORS in head and neck surgery has expanded considerably, there are still only limited data available on the postoperative complications and their management.

Intraluminal negative pressure wound therapy for optimizing pharyngeal reconstruction.

Importance: Pharyngocutaneous fistula formation after pharyngeal reconstruction is one of the most common and challenging problems to manage. Despite many advances in management, the published success rates indicate a role for any adjuvant therapy that could potentially decrease this complication.

Objective: To describe the use of intraluminal negative pressure dressings (NPDs) in pharyngeal reconstruction.

Negative pressure wound therapy in head and neck surgery.

IMPORTANCE Negative pressure wound therapy has been shown to accelerate healing. There is a paucity of literature reporting its use as a tool to promote wound healing in head and neck reconstruction. OBJECTIVE To review 1 institution's experience with negative pressure dressings to further describe the indications, safety, and efficacy of this technique in the head and neck.

Learning curve for transoral robotic surgery: a 4-year analysis.

Importance: As new institutions incorporate transoral robotic surgery (TORS) into their everyday practice, it is helpful to have a timeline reference of expected goals to follow as their experience increases. This article evaluates a single tertiary care academic institution's experience with TORS for head and neck tumors and reports its 4-year learning curve.

Objective: To evaluate a single institution's experience with TORS over a 4-year period and report treatment trends and clinical outcomes.

Hemorrhage after transoral robotic-assisted surgery.

Objective: An increasing number of head and neck surgeons have begun using transoral robotic-assisted surgery. Our objective was to examine the postoperative bleeding complications we have encountered to determine risk factors and to discuss the topic of hemorrhage control.

Study Design: Case series with chart review.

Assessment and incidence of salivary leak following laryngectomy.

Objectives/hypothesis: To determine the incidence and risk factors of pharyngocutaneous fistula formation in patients undergoing either primary or salvage laryngectomies and evaluate the role of barium esophagram in these patients.

Study Design: Retrospective cohort study.

Methods: Medical records of 259 patients who underwent total laryngectomy between 2003 and 2009 at our institution were reviewed.

Incidence and outcomes of stricture formation postlaryngectomy.

Objective: Postlaryngectomy stricture formation and dysphagia negatively affect quality of life and result in nutritional compromise. Understanding risk factors and successful treatment strategies may improve treatment outcomes.

Study Design: Historical cohort study.

Transoral robotic-assisted surgery for head and neck squamous cell carcinoma: one- and 2-year survival analysis.

Objective: to report 2-year survival outcomes for head and neck squamous cell carcinoma using transoral robotic-assisted resection.

Design: prospective case study.

Setting: two tertiary care centers.

Suspension laryngoscopy-assisted percutaneous dilatational tracheostomy in high-risk patients.

Objectives/hypothesis: To describe the outcomes of bedside percutaneous dilatational tracheostomy (PDT) extended to the care of high-risk patients in the intensive care unit (ICU) by the use of suspension laryngoscopy (SL) to secure the airway.

Study Design: Retrospective chart review.

Methods: The records of 117 consecutive patients who underwent suspension laryngoscopy-assisted percutaneous dilatational tracheostomy (SL-PDT) between April 2006 and May 2009 at our institution were reviewed.

Outcomes following temporal bone resection.

Objectives/hypothesis: To evaluate survival outcomes in patients undergoing temporal bone resection.

Study Design: Retrospective review.

Methods: From 2002 to 2009 a total of 65 patients underwent temporal bone resection for epithelial (n = 47) and salivary (n = 18) skull base malignancies.