Robotic-Assisted Tubular Transoral Parapharyngeal Approach to the Ventral Craniovertebral Junction

Background: Transoral robotic surgery (TORS) has become a routine technique for treating benign and malignant lesions of the oropharynx, with the advantage of reducing morbidity. It has not been previously combined with tubular minimally invasive techniques for accessing lesions of the spine at the craniovertebral junction.

Methods: We describe our technique of accessing the parapharyngeal space using the robotic technique, then dissecting the prevertebral muscles to expose the ventral craniovertebral junction. A tubular retraction with endoscpic visualization is then employed for surgical resection. We report a case of a 14-year-old competitive athlete who presented with an osseous lesion of C1 and underwent resection using this novel TORS approach.

Results: Our patient underwent successful resection of a lateral C1 osteoid osteoma utilizing a combined TORS/endoscopic approach. She immediately tolerated soft diet and discharged on postoperative day 2. Postoperative imaging revealed complete resection of the lesion and she returned to competitive athletics within 6 weeks.

Conclusion: Utilizing this novel, robotic-assisted approach can definitively treat osseous cervical spine lesions while reducing morbidity, allowing for early return to normal diet, and minimizing overall length of hospital stay.

Publication History

Article published online:
12 February 2021