Transoral robotic surgery in otorhinolaryngology: patient perspectives and determinants of outcomes
Transoral robotic surgery in otorhinolaryngology: patient perspectives and determinants of outcomes
Operating through the mouth with the help of a robot: this is transoral robotic surgery (TORS). The surgeon controls the robot, allowing precise surgery in hard-to-reach areas of the throat and at the back of the tongue. This means that invasive operations, which previously involved splitting the lower jaw, can now be avoided. In her thesis, Alexandra Toppenberg investigates which patients may benefit from TORS and what the treatment means for their symptoms and quality of life.
In patients with metastases in the neck whose original tumour was unknown, TORS enabled the tumour to be found in 40% of cases. TORS can also be used to remove throat tumours. Research into Dutch care for patients with an unknown primary tumour revealed considerable differences between hospitals. More consistent agreements could help improve care and allow better comparison of outcomes.
TORS also showed promising results in selected patients with sleep apnoea, a condition in which breathing repeatedly stops during sleep. Patients reported improvements in sleep, swallowing difficulties and quality of life. In patients with chronic inflammation of the tonsil tissue at the back of the tongue, symptoms decreased and swallowing-related quality of life improved.
Pain after surgery remains an important concern. Some patients experience considerable pain for several days. Effective pain management and patient education are therefore essential.
TORS offers opportunities but is not suitable for everyone. Careful patient selection, well-trained surgeons and further research are needed to determine who benefits most from this treatment.