Current Applications and Outcomes of Robotic Surgery in Pediatric Upper Airway and Neck Procedures: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
TORS | Transoral Robotic Surgery |
PRISMA | Preferred Reporting Items for Systematic Reviews and Meta-Analyses |
BOT | Base Of Tongue |
OSA | Obstructive Sleep Apnea |
LTGDC | Lingual Thyroglossal Duct Cyst |
TBR | Tongue Base Reduction |
TLM | Transoral Laser Microsurgery |
FAMM | Facial Artery Musculomucosal Flap |
SD | Standard Deviation |
n.a. | Not Available |
References
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Type of Study | Patients (n) | Mean Age (n ± SD) Years | Pathology | Localization | Procedure | Docking Time | Surgery Time | Da Vinci Si | Da Vinci Xi | Tracheotomy | Hospitalization Days | Complications | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Rahbar (2007) [4] | Retrospective | 2 | 5 | Laryngeal cleft (2) | Larynx | Laryngeal cleft repair (2) | n.a. | n.a. | 2 | 0 | 0 | n.a. | n.a. |
Kokot (2013) [15] | Case Report | 1 | 15 | Oropharyngeal synovial sarcoma | Oropharyngeal wall | Partial pharyngectomy and partial glossectomy | n.a. | n.a. | 1 | 0 | 1 | 3 | 0 |
Wine (2013) [16] | Case Report | 1 | 1, 5 | High grade undifferentiated sarcoma | Soft palate (oropharynx) | Resection of the left hemipalate and lateral oropharynx, partial base of tongue resection + FAMM | n.a. | 226 min | 1 | 0 | 0 | 16 | 0 |
Kayhan (2013) [17] | Case Report | 1 | 0, 2 | LTGDC | BOT | TBR | n.a. | 3 min | 1 | 0 | 0 | 3 | 0 |
Leonardis (2013) [18] | Retrospective study | 16 | 12 | OSA (11), disphagia (2), upper airway obstruction (1), upper airway obstruction due to exercise (1), lingual tonsillitis (1) | BOT | TORS | 6 min | 34 min | 16 | 0 | 2 | 1–13 | Minor bleeding (2), pneumonia (2), fever of unclear etiology (1), poor pain control (4) |
Ferrell (2014) [5] | Case series | 3 | 6 | Posterior glottic stenosis (1), laryngeal cleft (1), idiopathic bilateral vocal crod paralysis (1) | Larynx | Posterior cricoid spli with cartilage graft placement (1), simple repair (1), posterior cordectom + subtotal arytenoidectomy (1) Conversion needed (3) | n.a. | n.a. | 3 | n.a. | n.a. | 0 | Oral tongue edema, decreased oral intake, and suspected aspiration (5 days later) (1) |
Thottam (2015) [19] | Retrospective study | 9 | 10, 5 | OSA | BOT | TORS | n.a. | n.a. | 9 | 0 | 0 | 1–14 dqys | Bleeding (1), pneumonia (1) |
Carroll (2016) [20] | Case Report | 1 | 6 | LTGDC | BOT | Resection of tongue muscle with the mass. No hyoid bone resection | 15 min | 28 min | 1 | 0 | 0 | 1 | 0 |
Colaianni (2017) [21] | Case report | 1 | 9 | Epiglottic prolapse | Larynx | Robot-assisted Hyoepyglottopexy | n.a. | n.a. | 1 | 0 | 1 | n.a. | 0 |
Montevecchi (2017) [6] | Case series | 3 | 13, 25 | OSA | BOT | TORS (1), TORS + epiglottoplaty (1), TBR + epiglottoplasty + adenotonsillectomy (1) | 15 min | 60 min | 3 | 0 | 0 | 4, 66 | 0 |
Canevari (2017) [22] | Case report | 1 | 16 | Ewing Sarcoma | BOT | Partial glossectomy TORS | n.a. | n.a. | 1 | 0 | 0 | 2 | 0 |
Kayhan (2017) [7] | Case series | 8 | 5, 1 | LTGDC (4), vallecular cyst (1), lingual thyroid (1), minor salivqry gland tumor (1), bronchogenic cyst (1) | BOT | TORS | 6 min | 8.8 ± 6.9 min | 7 | 1 | 1 | 2, 25 ± 1.4 | Minor bleeding 10 days after surgery (1) |
Arnold (2018) [23] | Case report | 1 | 6 | neurofibroma | Supraglottic extending laterally into the parapharyngeal and carotid space | TORS | 40 min | 50 min | 0 | 1 | 1 | 23 | TLM laser CO2 for residual mass in left false vocal fold |
Turhan (2019) [24] | Case report | 1 | 0, 4 | LTGDC | BOT | excision | n.a. | 10 min | 0 | 1 | 0 | 7 | 0 |
Fanous A (2020) [25] | Case report | 1 | 6 | Branchial cyst I arch | Parapharyngeal space | TORS | n.a. | n.a. | 0 | 1 | 0 | 4 | 0 |
Venkatakarthikeyan (2020) [9] | Case series | 3 | 10, 66 | Dermoid cyst of BOT, Branchial cyst (II arch), acinic cell carcinoma | BOT, neck region, left parotid | Removal of the mass | 12, 33 min | n.a. | 0 | 3 | 0 | 2, 5 | 0 |
Lin HJ (2021) [8] | Prospective longitudinal cohort study | 4 | 4.4 | Congenital cervical lymphatic malformations | Neck region | Trans-hairline approach | 5.5 | 106 min | 2 | 2 | 0 | n.a. | Intraoperative injury to the external jugular vein (1) |
Johnston (2023) [12] | Case series | 7 | 8 | LTGDC (3 primary, 4 recurrent) | BOT | Removal of the mass + hyoid bone (4), removal of the mass (hyoid bone previously removed, 3) | n.a. | n.a. | 0 | 7 | 0 | 2, 3 | External fistula (1), minor bleeding |
Das (2023) [26] | Case report | 1 | 7 | LTGDC | BOT | TORS | n.a. | 10min | 0 | 1 | 0 | 7 | 0 |
Worden CP (2024) [14] | Retrospective study | 40 | 6, 41 | Laryngeal cleft (18), Lynphatic malformation (9), BOT mass (7), bilateral fold paralysis/posterior glottid stenosis (2), Aerodigestive Tract Stricture (6), Saccular Cyst/Neurofibroma (4) | Larynx, BOT | Removal of mass, correction of laryngeal cleft, release, TORS | n.a. | 145 min | 40 | n.a. | n.a. | 5.65 | Surgical failure/Required revision surgery (3), Granulation tissue/Granuloma (2), Post-extubation laryngospasm/bronchospasm (1) Aerodigestive tract stricture (1) Pneumonia (1) |
Condition Treated | n (%) |
---|---|
OSA-lingual tonsillar hypertrophy | 25 (22.7%) |
Laryngeal Cleft | 21 (19.1%) |
LTGDC | 15 (13.6%) |
BOT masses | 7 (6.3%) |
Cervical lymphatic malformations | 13 (11.8%) |
Malignant tumor * | 5 (4.5%) |
Cystic lesions ** | 10 (9.0%) |
Bilateral vocal fold paralysis or posterior glottic stenosis | 3 (2.7%) |
Lingual thyroid | 1 (0.9%) |
Aerodigestive tract strictures | 6 (5.5%) |
Epiglottic prolapse | 1 (0.9%) |
Exercise-induced respiratory difficulty | 1 (0.9%) |
Dysphagia | 2 (1.8%) |
Data | Results |
---|---|
Retrospective studies | 10 (50%) |
Case Report | 5 (25%) |
Case Series | 4 (20%) |
Prospective study | 1 (5%) |
Patients (n) | 104 |
Procedures (n) | 110 |
Mean Age | 7.9 years |
Da Vinci Si | 91 (82, 73%) |
Da Vinci Xi | 13 (11, 82%) |
Tracheostomy | 8 (7.69%) |
Hospitalization | 5.11 (± 5.66) |
Complications * | 28 (25.4%) |
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Visconti, I.C.; Reale, M.; Dallari, V.; Trecca, E.M.C.; Di Lullo, A.M.; Turri-Zanoni, M.; Gaffuri, M. Current Applications and Outcomes of Robotic Surgery in Pediatric Upper Airway and Neck Procedures: A Systematic Review. Children 2025, 12, 765. https://doi.org/10.3390/children12060765
Visconti IC, Reale M, Dallari V, Trecca EMC, Di Lullo AM, Turri-Zanoni M, Gaffuri M. Current Applications and Outcomes of Robotic Surgery in Pediatric Upper Airway and Neck Procedures: A Systematic Review. Children. 2025; 12(6):765. https://doi.org/10.3390/children12060765
Chicago/Turabian StyleVisconti, Irene Claudia, Marella Reale, Virginia Dallari, Eleonora M. C. Trecca, Antonella Miriam Di Lullo, Mario Turri-Zanoni, and Michele Gaffuri. 2025. "Current Applications and Outcomes of Robotic Surgery in Pediatric Upper Airway and Neck Procedures: A Systematic Review" Children 12, no. 6: 765. https://doi.org/10.3390/children12060765
APA StyleVisconti, I. C., Reale, M., Dallari, V., Trecca, E. M. C., Di Lullo, A. M., Turri-Zanoni, M., & Gaffuri, M. (2025). Current Applications and Outcomes of Robotic Surgery in Pediatric Upper Airway and Neck Procedures: A Systematic Review. Children, 12(6), 765. https://doi.org/10.3390/children12060765