Affiliation:
1. Department of Otolaryngology–Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
2. Department of Pathology and Laboratory Medicine University of North Carolina School of Medicine Chapel Hill North Carolina USA
3. Lineberger Comprehensive Cancer Center University of North Carolina School of Medicine Chapel Hill North Carolina USA
4. Carolina Ear, Nose & Throat–Sinus and Allergy Center, PA Hickory North Carolina USA
Abstract
AbstractObjectiveCompare surgical and swallow outcomes in robotic versus traditional laryngeal cleft (LC) repairs.Study DesignRetrospective cohort study.SettingTertiary care pediatric hospital.MethodsPediatric patients who underwent robotic or traditional (open or endoscopic) LC repair between 2010 and 2021 were identified. Patient characteristics, operative times, adverse events, hospital length of stay (LOS), and modified barium swallow study (MBSS) results were compared.ResultsEighteen robotic and thirty traditional LC repairs were identified. Mean surgical (149 vs 111 min, P < .05) and OR times (207 vs 139 min, P < .002) were increased for robotic type I LC repairs, but were similar for type II and III LC. Mean hospital LOS was increased for robotic type I LC repairs (2.6 vs 1.2 days, P < .006), but was decreased for type II (4 vs 12.2 days) and type III (4.3 vs 94.5 days) LC. Postoperative MBSS results were improved for robotic type I LC repairs at 12 months (82% vs 43%, P = .05), and trended toward improvement at 6 months for type II (75% vs 22%), and type III (67% vs 50%) LC repairs, although significance was limited for type II and III LC due to the number of subjects. A robotic approach was used successfully to revise all recurrent LC that failed traditional repairs.ConclusionRobotic type 1 LC repairs demonstrated increased operative times and hospital LOS but improved postoperative swallow outcomes compared to traditional approaches may be particularly useful in cases of recurrent clefts.