Our Summary

This research paper discusses a new way to perform surgery on a child with a type of tumor called a neurofibroma, which was located in the upper part of the throat and adjacent space. The procedure, called transoral robotic surgery (TORS), was used in combination with a delayed transoral laser microsurgery (TLM) for remaining disease. After the surgery, the child recovered very well. This case suggests that using robotic surgery in children is possible, safe, and can work well with laser microsurgery. Neurofibroma is one of many diseases in children’s airways that can be treated with surgery through the mouth. The use of TORS with TLM is expected to expand as doctors gain more experience with these methods.

FAQs

  1. What is the role of transoral robotic surgery (TORS) in managing pediatric neurofibroma?
  2. How does the combination of TORS and transoral laser microsurgery (TLM) improve patient outcomes after tumor resection?
  3. Can TORS and TLM be used for managing other pathologic processes of the pediatric airway apart from neurofibroma?

Doctor’s Tip

A doctor might advise a patient undergoing tumor resection to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding strenuous activities that could disrupt the healing process. It is also important for the patient to communicate any concerning symptoms or changes in their condition to their healthcare provider promptly.

Suitable For

Patients who are typically recommended tumor resection include those with tumors that are causing symptoms such as difficulty breathing, swallowing, or speaking, as well as tumors that are growing rapidly or are at risk of becoming malignant. In the case described, the patient had a pediatric neurofibroma with supraglottic and parapharyngeal space extension, which required surgical intervention to relieve symptoms and prevent further complications. Transoral robotic surgery (TORS) with delayed transoral laser microsurgery (TLM) was used to successfully resect the tumor, demonstrating the feasibility and safety of this approach in pediatric patients with airway tumors. The excellent functional outcomes in this case highlight the potential benefits of transoral surgery for managing a variety of pathologic processes in the pediatric airway.

Timeline

  • Patient presents with symptoms such as difficulty breathing, swallowing, or hoarseness
  • Imaging studies such as CT or MRI are performed to diagnose the tumor and determine its extent
  • Patient undergoes preoperative evaluations and consultations with a multidisciplinary team
  • Tumor resection surgery is scheduled and performed using transoral robotic surgery (TORS) and delayed transoral laser microsurgery (TLM)
  • Postoperatively, patient may experience pain, swelling, and difficulty speaking or swallowing
  • Patient undergoes follow-up appointments to monitor healing and function
  • Patient may require speech therapy or rehabilitation to regain full function of the affected area
  • Long-term follow-up is conducted to monitor for recurrence or complications.

What to Ask Your Doctor

  1. What is the goal of tumor resection in my case?
  2. What are the potential risks and complications associated with tumor resection surgery?
  3. What is the expected recovery time after tumor resection surgery?
  4. Will I need any additional treatments or therapies after the tumor resection?
  5. How will tumor resection surgery impact my quality of life and daily activities?
  6. What is the success rate of tumor resection surgery in cases similar to mine?
  7. Are there any alternative treatment options to consider besides tumor resection surgery?
  8. How often will I need follow-up appointments after tumor resection surgery?
  9. What can I do to prepare for tumor resection surgery and optimize my recovery?
  10. Are there any specific dietary or lifestyle changes I should make before or after tumor resection surgery?

Reference

Authors: Arnold MA, Mortelliti AJ, Marzouk MF. Journal: Laryngoscope. 2018 Nov;128(11):2525-2528. doi: 10.1002/lary.27186. Epub 2018 Mar 30. PMID: 29602216