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https://www.readbyqxmd.com/read/29236272/medical-malpractice-and-transoral-robotic-surgery-evaluation-and-some-preemptive-thoughts
#1
Daniel D Lydiatt, Ryan Sewell
Medical malpractice is costly and disruptive, and it is important to prevent. We conducted a study with the objective to look at medical malpractice in robotic surgery overall, to evaluate reasons for litigation, and to comment on possible strategies to avoid litigation with transoral robotic surgery. We used the Westlaw computerized database to identify all state and federal verdict summaries in medical malpractice cases. We found 17 cases alleging malpractice that involved the use of robotic surgery. In all, the plaintiffs in 6 cases (35%) contended that an open rather than a robotic approach should have been used, 5 (29%) alleged negligent credentialing, 4 (24%) alleged training deficiencies, 2 (12%) alleged manufacturing problems, and 1 (6%) charged that robotic surgery should have been performed instead of open surgery (1 case involved two of these allegations)...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29224814/transoral-robotic-surgery-based-therapy-in-patients-with-stage-iii-iv-oropharyngeal-squamous-cell-carcinoma
#2
Young Min Park, Hye Ryun Kim, Byoung Chul Cho, Ki Chang Keum, Nam Hoon Cho, Se-Heon Kim
OBJECTIVE: TORS-based therapy including chemotherapy or RTx was administered to patients with stage III-IV OPSCC. We analyzed the oncological and functional outcomes of stage III-IV OPSCC patients who underwent TORS-based therapy. MATERIALS AND METHODS: Between May 2008 and May 2016, 80 patients participated in this clinical trial. RESULTS: A negative margin was identified in 66 patients (82.5%) and a positive margin in 14 (17.5%). TNM stages were III in 13 patients (16...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224809/unplanned-readmission-following-transoral-robotic-surgery
#3
Michael C Topf, Amanda Vo, Patrick Tassone, Christopher Shumrick, Adam Luginbuhl, David M Cognetti, Joseph M Curry
OBJECTIVES: To determine the rate of unplanned readmission after transoral robotic surgery (TORS), and to determine which patient or surgical factors increase the likelihood of readmission. MATERIALS AND METHODS: Retrospective chart review of all patients who underwent TORS for squamous cell carcinoma at our institution from March 2010 through July 2016. Primary outcome was unplanned readmission to the hospital within 30 days of discharge. Univariable and multivariable logistic regression were performed to identify risk factors for unplanned readmission...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29214640/management-of-head-and-neck-primary-unknown-squamous-cell-carcinoma-using-combined-positron-emission-tomography-computed-tomography-and-transoral-laser-microsurgery
#4
Victoria Kuta, Blair Williams, Matthew Rigby, Robert Hart, Jonathan Trites, Colin MacKay, S Mark Taylor
OBJECTIVES/HYPOTHESIS: The unknown primary of the neck is commonly encountered by the head and neck surgeon. Despite the exhaustive diagnostic tools employed in traditional detection protocols, many unknown primaries are not found, and the patient is subjected to wide-field radiation and chemotherapy during treatment. Localizing the primary tumor has demonstrated therapeutic benefits, improved quality of life, and overall survival. The authors' objective was to determine the efficacy of a new management protocol for unknown primaries of the head and neck...
December 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29208591/the-second-look-procedure-for-transoral-videolaryngoscopic-surgery-for-t1-and-t2-laryngeal-oropharyngeal-and-hypopharyngeal-cancer-patients-protocol-for-a-nonrandomized-clinical-trial
#5
Goshi Nishimura, Daisuke Sano, Kenichiro Yabuki, Yasuhiro Arai, Yoshihiro Chiba, Teruhiko Tanabe, Nobuhiko Oridate
BACKGROUND: Transoral videolaryngoscopic surgery (TOVS) has been widely applied for early T stage head and neck cancer. The resection is performed with a minimum safety margin for function preservation under a limited surgical field of view, making it difficult to be certain of complete resection. OBJECTIVE: Our aim is the evaluation of the completeness of resection by initial TOVS resection, and the possibility of primary control by TOVS alone, allowing for repeat procedures for function preserving treatment in early T stage laryngeal, oropharyngeal, and hypopharyngeal cancer patients...
December 5, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29207815/anaesthetic-management-in-transoral-endoscopic-thyroidectomy
#6
Rajendra D Patel, Nisha Gowani, Manali Nadkarni, Sameer Rege, Priti Devalkar
Young females undergoing thyroid surgery are apprehensive about the surgical scar. This leads to the introduction of Transoral Endoscopic Thyroidectomy (TOET). TOET is gaining popularity for its minimally invasive and cosmetically sound approach to perform thyroidectomies in young patients. The surgical site being the mouth orifice poses a challenge to the anaesthesiologist to secure a definitive airway. The case report is that of a young female undergoing TOET for whom we have successfully performed nasal intubation with a North Pole ivory endotracheal tube (ET)...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29206695/drug-induced-sleep-endoscopy-from-obscure-technique-to-diagnostic-tool-for-assessment-of-obstructive-sleep-apnea-for-surgical-interventions
#7
Joshua H Atkins, Jeff E Mandel
PURPOSE OF REVIEW: Provide a practical update on drug-induced sleep endoscopy (DISE) for anesthesia providers, which can also serve as a reference for those preparing to establish a DISE program. RECENT FINDINGS: New developments in surgical approaches to OSA and the growing global incidence of the condition have stimulated increased interest and demand for drug-induced sleep endoscopy. New techniques include transoral robotic surgery and hypoglossal nerve stimulation...
December 4, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29206327/pharyngeal-perforation-after-anterior-cervical-spine-surgery-treated-by-transoral-endoscopic-surgery
#8
Julio Rama-López, Meritxell Tomás-Fernandez, César García-Garza, Milton Martínez-Madrigal
BACKGROUND: Anterior cervical fixation has been used since 1967 for multiple pathologies like traumatism, compressive myelopathy, or spinal infections. METHODS: We report the case of a patient who had undergone cervical spine surgery 10 years previously and presented to our clinic with a pharyngeal fistula due to surgical screw displacement that was treated by transoral endoscopic surgery. RESULTS: The immediate postoperative period occurred without incidence and complete odynophagia resolution...
December 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/29204587/transoral-robotic-surgery-vs-endoscopic-partial-midline-glossectomy-for-obstructive-sleep-apnea
#9
David Folk, Mark D'Agostino
Objective: To compare sleep-related outcomes in obstructive sleep apnea hypopnea syndrome (OSAHS) patients following base of tongue resection via robotic surgery and endoscopic midline glossectomy. Methods: This was a retrospective study. A total of 114 robotic and 37 endoscopic midline glossectomy surgeries were performed between July 2010 and April 2015 as part of single or multilevel surgery. Patients were excluded for indications other than sleep apnea or if complete sleep studies were not obtained...
June 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29204586/transoral-robotic-surgery-for-obstructive-sleep-apnea-syndrome-principles-and-technique
#10
Claudio Vicini, Filippo Montevecchi, Riccardo Gobbi, Andrea De Vito, Giuseppe Meccariello
Objective: The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: The review presents the experience of the robotic center that developed the technique with regards to patient selection, surgical method, and post-operative care. In addition, the review provides results of a systematic review and meta-analysis of the complications and clinical outcomes of TORS when applied in the management of OSAHS...
June 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29203314/endoscopic-transseptal-approach-with-posterior-nasal-spine-removal-a-wide-surgical-corridor-to-the-craniovertebral-junction-and-odontoid-technical-note-and-case-series
#11
Zefferino Rossini, Davide Milani, Federico Nicolosi, Francesco Costa, Giovanni Battista Lasio, Vincenzo Antonio D'Angelo, Maurizio Fornari, Giovanni Colombo
BACKGROUND: Transnasal approach to lesions involving the craniovertebral junction represents a technical challenge because of limited inferior exposure. The authors describe the endoscopic transseptal approach (ETsA) with posterior nasal spine (PNS) removal; this technique can create a wide exposition of the craniovertebral junction increasing the caudal exposure. METHODS: On patients undergoing anterior craniovertebral junction decompression, we calculated the degree of exposure on the sagittal plan through a paraseptal route, an ETsA without and with PNS removal...
December 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29194991/hemorrhage-following-transoral-robotic-surgery-tors
#12
Ashley Hay, Jocelyn Migliacci, Daniella Karassawa Zanoni, Jay O Boyle, Bhuvanesh Singh, Richard J Wong, Snehal G Patel, Ian Ganly
BACKGROUND: To report our experience of postoperative hemorrhage in patients following transoral robotic surgery (TORS). METHODS: Data was collected on patients having TORS. Postoperative hemorrhage within 30 days was graded using the Mayo clinic grading system. RESULTS: TORS operations were performed on 122 patients. There were 23 bleeding events classified as minor to severe following 19 operations (16%). Hemorrhage requiring a return to the operating room occurred after 7 operations (6%)...
December 1, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29192878/motion-preserving-2-stage-transoral-and-posterior-treatment-of-an-unstable-jefferson-fracture-in-a-professional-football-player
#13
Gerald E Rodts, Griffin R Baum, Fermin G Stewart, John G Heller
The authors report the case of a patient who suffered a Jefferson fracture during a professional football game. The C-1 (atlas) fracture was widely displaced anteriorly, but the transverse ligament was intact. In an effort to enable a return to play and avoid intersegmental (C1-2) fusion, the patient underwent a transoral approach for open reduction and internal fixation of the fracture. The associated posterior ring fracture displacement widened after this procedure, and a subsequent posterior arthrodesis and fixation of the fracture site was performed 6 months later when the fracture failed to heal with rigid collar immobilization...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29187946/the-endoscopic-endonasal-approach-to-cranio-cervical-junction-the-complete-panel
#14
REVIEW
Nouman Aldahak, Bertram Richter, Joseph Synèse Bemora, Jeffery Thomas Keller, Sebastien Froelich, Khaled Mohamed Abdel Aziz
We aim to establish a complete summary on the Endoscopic Endonasal Approach (EEA) to Cranio Cervical Junction (CCJ): evolution since first description, criteria to predict the feasibility and limitations, anatomical landmarks, indications and biomechanical evaluation after performing the approach. A comprehensive literature search to identify all available literature published between March 2002 and June 2015, the articles were divided into four categories according to their main purpose: 1- surgical technique, 2- anatomical landmarks and limitations, 3- literature reviews to identify main indications, 4- biomechanical studies...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29187728/pleomorphic-adenoma-of-the-posterior-surface-of-the-soft-palate-causing-sleep-disturbance-a-case-report
#15
Uzdan Uz, Onur Celik
BACKGROUND Pleomorphic adenoma is the most common benign tumor arising in the salivary gland. The signs and symptoms of pleomorphic adenoma of the minor salivary glands vary, depending on the anatomical site involved. A rare case of pleomorphic adenoma of the posterior surface of the soft palate is reported that caused sleep disturbance, which was resolved with endoscopic surgical treatment. CASE REPORT A 32-year-old woman experienced snoring and mouth-breathing during sleep. Flexible fiberoptic nasopharyngoscopy imaging of the oropharyngeal passage showed obstruction by a tumor the soft palate, which obstructed the oropharyngeal passage...
November 30, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29183011/transoral-robotic-surgery-with-sialendoscopy-for-a-plunging-ranula
#16
Ryan M Carey, Benjamin L Hodnett, Christopher H Rassekh, Gregory S Weinstein
BACKGROUND/AIMS: Plunging ranulas are oral mucoceles that often cannot be visualized directly and thus can be challenging to diagnose and differentiate from other neck lesions. Surgery is the preferred treatment option, but the optimal approach requires careful consideration. METHODS: We report the case of a plunging ranula presenting as an isolated neck mass in a 33-year-old patient. This patient was treated with a novel transoral robotic surgery (TORS)-assisted approach aided by sialendoscopy...
November 29, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/29182490/positive-margins-by-oropharyngeal-subsite-in-transoral-robotic-surgery-for-t1-t2-squamous-cell-carcinoma
#17
Michael J Persky, William G Albergotti, Tanya J Rath, Mark W Kubik, Shira Abberbock, Mathew Geltzeiler, Seungwon Kim, Umamaheswar Duvvuri, Robert L Ferris
Objective To compare positive margin rates between the 2 most common subsites of oropharyngeal transoral robotic surgery (TORS), the base of tongue (BOT) and the tonsil, as well as identify preoperative imaging characteristics that predispose toward positive margins. Study Design Case series with chart review. Setting Tertiary care referral center. Subjects and Methods We compared the final and intraoperative positive margin rate between TORS resections for tonsil and BOT oropharyngeal squamous cell carcinoma (OPSCC), as well as the effect of margins on treatment...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29181172/trigeminal-neurofibroma-in-the-infratemporal-fossa-arising-from-the-inferior-alveolar-nerve-a-case-report
#18
Takuro Inoue, Mostafa Elaskary, Ayako Shima, Hisao Hirai, Fumio Suzuki, Masayuki Matsuda
Solitary neurofibromas arising from cranial nerves are rare, and those arising from the peripheral divisions of the trigeminal nerve are even rarer. Although infratemporal fossa (ITF) masses are challenging to remove, certain approaches are considered feasible for this region. The present study reports a rare case of an ITF neurofibroma arising from the inferior alveolar nerve. The 27-year-old male patient presented with numbness of the right jaw. A radiological examination revealed a large mass occupying the ITF, from the mandible to the foramen ovale, originating from the inferior alveolar nerve in the mandible...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29176297/treatment-of-a-large-pharyngeal-venous-malformation-using-transoral-sclerotherapy
#19
Asako Kuhara, Norimitsu Tanaka, Tomoko Kugiyama, Masamichi Koganemaru, Kensuke Kiyokawa, Toshi Abe
Management of venous malformation (VM) in the pharynx is challenging because of difficulties in needle access and the presence of nerves as well as other critical anatomical structures around the lesion. We describe the successful treatment of a large pharyngeal VM using transoral sclerotherapy. The patient, a 21-yearold male, visited our hospital for sclerotherapy treatment consultation after complaining of difficulty in swallowing because of a pharyngeal VM. Transoral sclerotherapy was successful, and the symptoms showed complete alleviation...
November 27, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/29160154/staging-neck-dissection-and-transoral-robotic-surgery-treatment-algorithm-in-palatine-tonsil-cancer
#20
Joseph Spellman, Ryan Sload, Paul Kim, Peter Martin, Gabriel Calzada
Objective This study introduces a treatment algorithm based on staging neck dissection to identify patients with palatine tonsil squamous cell carcinoma who can be effectively treated with single-modality transoral robotic surgery while maintaining quality of life. Study Design Retrospective case series. Setting Kaiser Permanente Southern California Medical Group from 2012 to 2017. Subjects and Methods Patients with early-stage (T1/2) palatine tonsil squamous cell carcinoma with clinically and radiographically N0 necks underwent staging neck dissection...
November 1, 2017: Otolaryngology—Head and Neck Surgery
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