TY - JOUR
T1 - Preoperative predictors of difficult oropharyngeal exposure for transoral robotic surgery
T2 - The Pharyngoscore
AU - Gaino, Francesca
AU - Gorphe, Philippe
AU - Vander Poorten, Vincent
AU - Holsinger, F. Christopher
AU - Lira, Renan B.
AU - Duvvuri, Umamaheswar
AU - Garrel, Renaud
AU - Van Der Vorst, Sebastien
AU - Cristalli, Giovanni
AU - Ferreli, Fabio
AU - De Virgilio, Armando
AU - Giannitto, Caterina
AU - Morenghi, Emanuela
AU - Colombo, Giovanni
AU - Malvezzi, Luca
AU - Spriano, Giuseppe
AU - Mercante, Giuseppe
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: Insufficient exposure may require termination of procedure in transoral robotic surgery (TORS). The aim of study was to develop a “Pharyngoscore” to quantify the risk of difficult oropharyngeal exposure (DOE) before TORS. Methods: Three-hundred six patients undergoing any surgical procedure at one Academic Hospital were prospectively enrolled. Oropharynx was exposed with Feyh–Kastenbauer retractor. Exposure was evaluated by direct and endoscopic visualization of the four oropharyngeal subsites. Preoperative clinical/anthropometric parameters were studied in good oropharyngeal exposure and DOE groups. Logistic regression was performed to explore association between clinical/anthropometric parameters and DOE. Statistically significant parameters at multivariate analysis were incorporated into a nomogram. Results: Sixty-five (21.2%) subjects were characterized by DOE. Variables associated with DOE at univariate analysis were male (p = 0.031), modified Mallampati Class (MMC) ≥ III (p < 0.001), smaller interincisor gap (p < 0.001), and larger neck circumference (p = 0.006). MMC, interincisor gap, and neck circumference were significant at multivariate analysis and were presented with a nomogram for creating the Pharyngoscore. Conclusions: The Pharyngoscore is a promising tool for calculating DOE probability before TORS.
AB - Background: Insufficient exposure may require termination of procedure in transoral robotic surgery (TORS). The aim of study was to develop a “Pharyngoscore” to quantify the risk of difficult oropharyngeal exposure (DOE) before TORS. Methods: Three-hundred six patients undergoing any surgical procedure at one Academic Hospital were prospectively enrolled. Oropharynx was exposed with Feyh–Kastenbauer retractor. Exposure was evaluated by direct and endoscopic visualization of the four oropharyngeal subsites. Preoperative clinical/anthropometric parameters were studied in good oropharyngeal exposure and DOE groups. Logistic regression was performed to explore association between clinical/anthropometric parameters and DOE. Statistically significant parameters at multivariate analysis were incorporated into a nomogram. Results: Sixty-five (21.2%) subjects were characterized by DOE. Variables associated with DOE at univariate analysis were male (p = 0.031), modified Mallampati Class (MMC) ≥ III (p < 0.001), smaller interincisor gap (p < 0.001), and larger neck circumference (p = 0.006). MMC, interincisor gap, and neck circumference were significant at multivariate analysis and were presented with a nomogram for creating the Pharyngoscore. Conclusions: The Pharyngoscore is a promising tool for calculating DOE probability before TORS.
KW - oropharyngeal cancer
KW - oropharyngeal exposure
KW - OSAS
KW - TORS
KW - transoral robotic surgery
UR - http://www.scopus.com/inward/record.url?scp=85107962493&partnerID=8YFLogxK
U2 - 10.1002/hed.26792
DO - 10.1002/hed.26792
M3 - Article
C2 - 34132440
AN - SCOPUS:85107962493
SN - 1043-3074
VL - 43
SP - 3010
EP - 3021
JO - Head and Neck
JF - Head and Neck
IS - 10
ER -