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Article Dans Une Revue Head & Neck Année : 2021

Preoperative predictors of difficult oropharyngeal exposure for transoral robotic surgery: The Pharyngoscore

Renan Lira
  • Fonction : Auteur
Giovanni Cristalli
  • Fonction : Auteur

Résumé

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.
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Dates et versions

hal-03651305 , version 1 (25-04-2022)

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Francesca Gaino, Philippe Gorphe, Vincent Vander Poorten, F. Christopher Holsinger, Renan Lira, et al.. Preoperative predictors of difficult oropharyngeal exposure for transoral robotic surgery: The Pharyngoscore. Head & Neck, 2021, 43 (10), pp.3010-3021. ⟨10.1002/hed.26792⟩. ⟨hal-03651305⟩
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