Voice Outcomes After Transoral Robotic Surgery Compared to Conventional Approaches

Robotic surgery through oral cavity has been developed as a surgical approach for thyroid cancer and head and neck malignancies. In general, transoral robotic surgery for the treatment of oropharyngeal and laryngeal cancers is referred to as transoral robotic surgery (TORS), whereas transoral robotic surgery performed for thyroidectomy is referred to as transoral robotic thyroidectomy (TORT). Initially introduced for the management of oropharyngeal carcinoma within the field of head and neck surgery, advancements in robotic technology and surgical techniques have expanded its indications to include laryngeal cancer and thyroid cancer. Recently, TORS and TORT have been increasingly utilized in clinical practice. For thyroid cancer, TORS is performed via an incision between the mandible and the lower lip mucosa, allowing a cranial-to-caudal operative approach. When an additional axillary incision is not employed, this technique represents the only surgical approach that avoids any cutaneous incision for the treatment of thyroid tumor. Furthermore, in the management of oropharyngeal and laryngeal cancers, TORS enables resection of the primary tumor without the need for external skin incisions, although neck dissection requires neck skin incision. Despite the disadvantages of increased cost and longer operative time, TORS and TORT are widely recognized for its superior cosmetic outcomes. However, it is important to evaluate potential advantages beyond aesthetic benefits. The present study with narrative review aims to investigate voice outcomes of TORS and TORT compared with conventional transcervical open approaches through a comprehensive review of the literature