Enver Ozer, MD, Associate Clinical Professor highlights the importance of using robotics for head and neck surgeries.
Head and Neck Cancer Procedures
Ohio State is one of only a few institutions performing transoral robotic surgery (TORS), an alternative to chemoradiotherapy and traditional open surgery for patients with head and neck cancer. TORS is a minimally invasive surgery that eliminates the need for open surgery’s long incisions through the throat and jaw, which often leave patients with visible scars, difficulty breathing or swallowing following surgery, and a lengthy recovery.
As one of the highest volume programs, over the past five years our surgical team has performed more than 200 robotic surgeries to remove:
• Tongue-based cancers
• Tonsil cancers
• Top portion of the voice box cancers
• Recurrent nasopharyngeal tumors
• Skull-based tumors
Transoral robotic surgery is on its way to becoming the standard surgical approach for head and neck cancers. TORS helps reduce the impact of treatment on their lives with results that include:
• Shorter surgery, 24 minutes on average, versus three to four hours for open surgery
• Shorter hospital stay, typically one night
• Less blood loss, pain and scarring
• Fewer tracheotomies and stomach tubes needed
• Faster recovery and return to normal speech and swallowing
The revolutionary procedure involves a small hidden incision in the armpit that allows the surgeon to make a tunnel under the skin to the thyroid area. The surgeon removes the diseased thyroid through the tunnel. Patients are typically discharged from the hospital in one to three days. Ohio State is in an elite group of only 35 medical centers nationwide offering robotic thyroidectomies and the first in Ohio to perform robotic thyroidectomies.
Surgeons at Ohio State collaborate across disciplines using a revolutionary approach to reach and remove skull base tumors. Internationally known endoscopic surgeons Ricardo Carrau, MD, professor of Otolaryngology and director of the Department's Cranial Base Surgery Program, and Daniel Prevedello, MD, associate professor of Neurological Surgery and director of Ohio State's Minimally Invasive Cranial Surgery Program, pioneered an endoscopic endonasal procedure that removes skull-based tumors through the nose.
Ricardo Carrau, MD, Professor of Otolaryngology and Director of the Department's Cranial Base Surgery Program describes the state-of-the-art technology used to remove skull-based tumors through the nose.
This technique has important advantages for patients:
• Avoids scars from facial or scalp incisions
• Prevents the need for a craniotomy and retracting the brain to reach the tumor, which reduces the risk of tissue swelling and of cognitive or personality changes that sometimes follow traditional skull base surgery
• Allows patients to typically recover faster and have shorter hospital stays
Surgeons work through both nostrils using an endoscope, and through the mouth with robotic assisted instruments, to gain access to the base of the skull, intracranial cavity and top of the spine.
Pairing these techniques gives surgeons access to tumors that are difficult to reach, including those considered to be inoperable. This procedure provides a minimally invasive approach to managing conditions such as:
• Benign intracranial tumors (pituitary, adenoma, meningioma, craniopharyngioma and schwannoma)
• Malignant cranial base tumors (chordoma, chondrosarcoma, olfactory neuroblastoma)
• Benign cranial base disorders (encephaloceles, mucoceles, cerebrospinal fluid leak, osteomas)
• Benign sinonasal tumors (inverted papilloma, nasal polyps)
• Malignant sinonasal tumors (squamous cell carcinoma, adenocarcinoma)
Ohio State is one of only 10 centers in the country providing comprehensive care for skull base tumors. Patients have ready access to the core members of their team at one location, including their head and neck surgeon, neurosurgeon, reconstructive surgeon, and nurse practitioners, as well as endocrinologists, ophthalmologists, speech and swallowing therapists and prosthetic experts, if needed.
Head and Neck Cancer Research
Research is vital to advancing the reach of robotic surgery. As a national leader in the field, it’s why we’re invested in participating in clinical trials to continually develop new procedures and improve current techniques so we can give patients access to the best treatment possible. Surgeons are leading a pioneering clinical trial studying the use of TORS for oral and laryngopharyngeal benign and malignant lesions, and published the first report on the use of TORS for nasopharyngeal lesions. In addition, we’re involved in ongoing research studying clinical and quality of life outcomes for patients undergoing TORS. We are also part of research and have published findings on the use of TORS for:
• Lingual tonsillectomies
• Nasopharyngeal lesions
• Supraglottic laryngectomies
• Managing upper aerodigestive tract tumors
"Patients have improved quality of life outcomes through this surgery." -- Enver Ozer, MD, Associate Clinical Professor