RESUMO
Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb. The aim of our work was to prove the feasibility and the benefits in terms of reducing sequelae when using a thin anterolateral perforator flap harvested above the plane of the superficial fascia. We present this new original method in detail and the advantages it offers to patients after surgery.
Assuntos
Satisfação do Paciente , Retalho Perfurante/transplante , Neoplasias Faríngeas/cirurgia , Procedimentos Cirúrgicos Robóticos , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Estudos Prospectivos , Procedimentos de Cirurgia Plástica/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do TratamentoRESUMO
The transoral robotic oropharyngectomy surgical technique was initially described for resection of small stage T1 or T2 lesions and the surgical defect is usually allowed to heal by secondary intention. We propose a refined surgical approach adapted to more complex situations such as salvage surgery and surgery in an irradiated field, based on previous experience in open approaches for oropharyngeal cancer. Via a combined cervical-transoral approach, we perform en bloc resection of the parapharyngeal space combined with transoral robotic lateral oropharyngectomy. Reconstruction of the surgical defect is performed with a thin anterolateral thigh free flap.