Robotic nasopharyngectomy

Surgery of the nasopharynx is challenging owing to its encasement within the craniofacial skeleton and proximity of vital neurovascular structures. Traditional open surgery involves significant resection or transposition of obstructing bone and soft tissue. The level of invasiveness is reduced in endoscopic nasopharyngectomy, but a 4-handed technique has problems of soft tissue and bony constraints and instruments clashing. The distally actuated robotic instruments and ability to control more than 1 instrument has prompted the development of various techniques of robotic nasopharyngectomy, both on cadavers and live patients. We review some of these approaches and include our hybrid endoscopic and robotic approach to nasopharyngectomy.