Transoral robotic surgery-assisted excision of a congenital cervical salivary duct fistula presenting as a branchial cleft fistula

Abstract

TORS was helpful for management of a congenital salivary fistula and may be helpful for branchial cleft fistulae. These lesions may be associated with the branchio-oto-renal (BOR) syndrome.

Transoral robotic surgery advantages and disadvantages: a narrative review

“…Through TORS, surgeons have been able to visualise areas and successfully inset free flaps in a minimally invasive manner [17]. Although there were complications through the above applications such as a few cases of mild dysphonia, negative final frozen section margins [61] and increased risk of severe short‐term dysphagia and dysphagia‐related complications in retrophangeal lymph nodes (RPLNs) cases [29], high completion rate in comparison with other transoral surgical procedures was achieved [23–25], reserving as much swallowing and speech as possible [10, 57] and there was no need for gastrointestinal tube postoperatively [23–25].…”

“…The last one includes publications for TORS in paediatric patients with head and neck cancer [21, 22] and more rare tumours such as Ewing's sarcoma of the tongue [20] (see Table 1). Pharynx [23–30] : This category includes the publications for TORS in pharynx [23–25], nasopharynx (NP) [26] – located to the upper part of the pharynx –, parapharynx space tumours [27, 28] – located deep within the neck and it is a potential space lateral to the upper pharynx – and retropharynx [29, 30] – which is the posterior part of the pharynx – (see Table 2). Oropharynx [1, 31–52] : This category includes all the publications related to TORS, which refer to oropharyngeal carcinomas and tumours.…”

Alternative Applications of Trans-Oral Robotic Surgery (TORS): A Systematic Review

“…Trans-oral removal of lingual thyroglossal cyst has also been presented, offering an alternative procedure to the conventional Sistrunk technique [10]. Other conditions have been mentioned as being treated by TORS, such as a salivary duct fistula at the level of posterior tonsillar pillar [11], schwannomas and vascular lesions of the tongue base, and even the removal of a foreign body embedded in the lingual tonsil [12,13]. Since not only adults but also the paediatric population can be affected by OSAS, and as thyroglossal cyst and ectopic thyroid are congenital pathologies, TORS has potential applications in the paediatric population, despite the obvious added anatomical limitations in access [14].…”

Branchial Cleft Anomalies: Embryogenesis, Clinical Features, Diagnosis, and Management

“…56 Guerrissi 57 was the first to describe this technique and demonstrated excellent visualization of a second BCA fistulous tract through a minimal skin incision. Magdy et al 58 demonstrated similar success using intraluminal endoscopy to facilitate visualization of the fistula, while Rassekh et al 59 describe the resection of the pharyngeal component of a BCA fistula using a robotic-assisted minimally invasive approach. Sclerotherapy using OK-432 and various chemocauterization techniques have also been described but carry a risk of collateral injury to surrounding structures.…”