• Title/Summary/Keyword: Transoral surgery

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Comparison of the clinical results between endoscopically assisted transoral approach and retromandibular approach for surgical treatment of mandibular subcondyle fracture

  • Lee, Woo-Yul;Cho, Jin-Yong;Yang, Sung-Won
    • The Journal of the Korean dental association
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    • v.54 no.12
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    • pp.1045-1054
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    • 2016
  • Purpose : Aim of this study is to describe and compare clinical results and complications epending on the surgical approaches for the mandibular subcondyle fracture Materials and methods : The patients who had been diagnosed as the mandibular subcondyle fracture and underwent open reduction and internal fixation from May 2009 to December 2014 were included. They were divided into two groups depending on the surgical approaches; endoscopically assisted transoral approach and retromandibular approach. Association between the preoperative fracture classification and post-operative results was reviewed depending on the surgical approaches. Results : The number of patients selected in this study was 33. Eighteen patients (male 7, female 11) underwent open reduction and internal fixation via retromandibular approach and fifteen patients (male 12, female 3) underwent open reduction and internal fixation via endoscopically assisted transoral approach. The mean age, follow up period, and operation time were $44.29{\pm}15.19years$, $9.97{\pm}7.82months$, and $161{\pm}89.44minutes$. Post-operative results were all "good" state in the retromandibular approach group regardless of the fracture classification but two patients in the endoscopically assisted transoral approach group underwent re-operation due to "poor" results. The fracture types of two were classified as displacement and lateral override at the same time. There was no statistically significant difference between two groups. Three patients in the retromandibular approach group had experienced facial nerve palsy (17%) temporarily. No one showed malocclusion in this study. There was no significant difference on the complications such as temporomandibular disorder, local infection, and condyle resorption depending on the surgical approaches. Conclusion : In this study, there was no significant difference on the complications between the two groups but retromandibular approach has advantage over endoscopically assisted transoral approach in case of the severely displaced subcondyle fracture.

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A Case of Contralateral Hypoglossal Nerve Palsy after Peroral Resection of Submandibular Gland (경구강 악하선 절제술 후 발생한 반대측 설하신경 마비 1례)

  • Ban, Won Woo;Ban, Myung Jin;Lee, Chi-Kyou;Park, Jae Hong
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.1
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    • pp.41-44
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    • 2016
  • The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

A Case of Transoral Approach of a Parapharyngeal Schwannoma (부인두강에 발생한 신경초종에 대한 경구강 접근법 1례)

  • Bong, Jeong-Pyo;Kim, Sung-Il;Kwon, Jang-Woo;Kim, Sung-Kyun
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.214-216
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    • 2008
  • Parapharyngeal space tumors are extremely rare accounting for about 0.5% of all head and neck tumors and treat mostly by surgical removal. Due to their inherent location, they present with varied non-specific signs and symptoms, resulting in a delay in diagnosis and unnecessary procedures, such as a 'tonsillectomy' or 'incision and drainage' of a 'quinsy'. We recently confirmed a case about a the neurilemnoma on parapharyngeal space during tonsillectomy. To present our experience with the transoral approach for parapharyngeal space tumor and describe our technique for removal of these neoplasms. Although parapharyngeal space tumours are uncommon, recognizing them would enable the correct sequence of investigations, instead of unnecessary procedures resulting in an increased morbidity for the patient.

Transoral Drainage of Plunging Ranula using Intraoperative Ultrasonography after Sublingual Gland Resection: A Case Report (설하선 절제술 후 수술 중 초음파를 이용한 몰입성 하마종의 경구강 배액술)

  • Seo Bin Kim;Yeong Joon Kim;So Yeon Lee;Hyoung Shin Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.49-52
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    • 2023
  • Sublingual resection is known as the most effective treatment of choice to prevent recurrence in patients with plunging ranula. In this case report, we present our experience with a 37 year-old man with prolonged upper neck mass diagnosed as plunging ranula. He had persisting mass lesion even after 4 times of sclerotherapy. Due to fibrotic change the pseudocyst could not be drained after removing the sublingual gland. To resolve the mass lesion, ultrasonography guided transoral drainage was performed. Intraoperative ultrasonography may be useful for transoral drainage of plunging ranula difficult to approach after sublingual resection.

Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study

  • Khandeparker, Purva Vijay Sinai;Dhupar, Vikas;Khandeparker, Rakshit Vijay Sinai;Jain, Hunny;Savant, Kiran;Berwal, Vikas
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.3
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    • pp.144-150
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    • 2016
  • Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P -value less than 0.05 was considered significant. Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

Robot-Assisted Transoral Odontoidectomy : Experiment in New Minimally Invasive Technology, a Cadaveric Study

  • Yang, Moon-Sul;Yoon, Tae-Ho;Yoon, Do-Heum;Kim, Keung-Nyun;Pennant, William;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.248-251
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    • 2011
  • Objective : In the field of spinal surgery, a few laboratory results or clinical cases about robotic spinal surgery have been reported. In vivo trials and development of related surgical instruments for spinal surgery are required before its clinical application. We investigated the use of the da $Vinci^{(R)}$ Surgical System in spinal surgery at the craniovertebral junction in a human cadaver to demonstrate the efficacy and pitfalls of robotic surgery. Methods : Dissection of pharyngeal wall to the exposure of C1 and odontoid process was performed with full robotic procedure. Although assistance of another surgeon was necessary for drilling and removal of odontoid process due to the lack of appropriate end-effectors, successful robotic procedures for dural sutures and exposing spinal cord proved its safety and dexterity. Results : Robot-assisted odontoidectomy was successfully performed in a human cadaver using the da $Vinci^{(R)}$ Surgical System with few robotic arm collisions and minimal soft tissue damages. Da $Vinci^{(R)}$ Surgical System manifested more dexterous movement than human hands in the deep and narrow oral cavity. Furthermore, sutures with robotic procedure in the oral cavity demonstrated the advantage over conventional procedure. Conclusion : Presenting cadaveric study proved the probability of robot-assisted transoral approach. However, the development of robotic instruments specific to spinal surgery must first precede its clinical application.

Retromandibular Approach versus an Endoscope-assisted Transoral Approach to Treat Subcondylar Fractures of the Mandible (하악과두하 골절 시 후하악 접근법과 내시경을 이용한 구강 내 접근의 비교)

  • Kim, Dong-Woo;Park, Dae-Song;Lee, Sang-Chil;Kim, Sung-Yong;Lim, Ho-Yong;Yeom, Hak-Yeol;Kim, Hyeon-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.497-504
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    • 2011
  • Purpose: Patients who had a subcondylar fracture with a displaced or deviated condylar segment were treated with a retromandibular approach (RMA) or an endoscope-assisted transoral approach (EATA) in our department of oral and maxillofacial surgery. The clinical results of the approaches were compared. A comparative study of specific approaches for subcondylar fractures has not been published before in Korea. Methods: Twenty-one patients with subcondylar fractures of the mandible were included. Ten patients were treated with the retromandibular approach and 11 were treated with an endoscope-assisted transoral approach. We examined patient age, gender, fracture sites, classifications, period of maxillomandibular fixation, facial nerve (FN) or greater auricular nerve (GAN) injuries, maximal mouth opening, deflection, occlusal changes, number of plates, follow-up period, and other complications. Preoperative computed tomography and pre-operative, post-operative, and follow-up panoramic views were taken of each patient. Results: Mean maximal mouth openings were similar between the two approaches. FN and GAN injuries were more frequent in the RMA group but the deflective rate with mouth opening was higher in the EATA than that in RMA group. Two cases of post-operative infection occurred in the EATA group, and occlusal changes were observed in one case for both approaches. Conclusion: The RMA offers more direct access and visualization of the surgical field but it can cause scars and retractive injuries of the FN and GAN. But, EATA did not result in consequent nerve injuries or scars postoperatively, but unfavorable fractures such as $medial$ $override$ condyles were more difficult to reduce endoscopically. Except cases of an expected difficult reduction, the treatment of choice for a displaced subcondylar fracture may be an EATA.

A Case of Partial Pharyngectomy Using Transoral Robotic Surgical System in Hypopharyngeal Cancer (경구강 로봇을 이용해 시행한 근치적 하인두암 이상와 절제술 1례)

  • Park, Young-Min;Jung, Jin-Sei;Baek, Seung-Jae;Kim, Won-Shik;Choi, Eun-Chang;Kim, Se-Heon
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.47-51
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    • 2009
  • Hypopharyngeal cancer have shown poor prognosis though various treatment modalities were developed for several decades. Therefore current trend in managing hypopharyngeal cancer is organ preservation therapy to improve patient's quality of life. Recently, surgery via robotic surgical system in genitourinary surgery improved minimal invasive technique and reduced morbidity dramatically. Hypopharyngeal cancer treatment using Transoral robotic surgery (TORS) in treating lesions of hypopharynx could reduce the morbidity and achieve organ preservation.

Transoral $CO_2$ Laser Microsurgery for Laryngeal Lesions (후두질환에서 경구강 $CO_2$ 레이저 미세수술)

  • Lee, Sang-Joon;Chung, Phil-Sang
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.112-120
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    • 2010
  • Transoral $CO_2$ laser microsurgery has been widely used for various laryngeal diseases. Laser cordectomy for the management of early laryngeal carcinoma has advantages with regards to oncologic results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. $CO_2$ laser is also applicable to benign vocal fold lesions such as nodules, polyps, cysts, reinke's edema, granulomas, papillomas, hemangiomas and glottis webs. $CO_2$ laser is suitable for microsurgery because it has small focus size and hemostatic effect. We should also recognize the risks of $CO_2$ laser for safe use.

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