Transoral robotic surgery for supraglottic neoplasms

Treatment of supraglottic neoplasms is complex, balancing the goal of maintaining oncologic principles while preserving laryngeal functions is challenging. Traditional treatment modalities include radiotherapy, chemotherapy, and surgical approaches. A trend toward endoscopic, trans-oral surgery for early stage lesions has resulted in improved postoperative function, decreased morbidity, and shorter hospital stays as compared to open surgery. In recent years, there has been the advancement of trans-oral robotic approaches for oral cavity and oropharyngeal malignancies. The robot has the advantage of high-definition and 3D visualization, improving intraoperative margin assessment during primary resection. Further there is improved dexterity, precision, and control of instruments with 7 degrees of freedom, 90 degrees of articulation, motion scaling, and tremor reduction afforded by the robot. By coupling this technology with the trans-oral approach, optimization of surgical outcomes is possible. This chapter describes the nuances of trans-oral robotic surgery for supraglottic neoplasms.