Transoral robotic reconstruction of a posterior palatal defect using an upper arm flap following polymorphous adenocarcinoma resection: a novel minimally invasive approach.
Henning Wieker, Juliane Wagner, Jörg Wiltfang et al.
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Case in brief
A 36-year-old female presented with a 1 × 1 cm swelling on the palate, diagnosed as a polymorphous adenocarcinoma after resection. Following oncologically adequate removal of the tumor and surrounding tissue, a 3 × 4 cm defect was reconstructed using a free upper arm flap via a transoral robotic approach. The patient had an uneventful recovery, with ongoing rehabilitation for speech and swallowing.
What made this case unusual
The use of the Symani ® robotic surgical system for supermicrosurgery allowed for transoral reconstruction with anastomoses at a vessel diameter of approximately 0.2 mm, which is a novel application in this context.
Diagnostic / clinical pearl
Clinicians should consider the potential of robotic-assisted techniques for complex reconstructions in head and neck oncology, particularly for minimizing donor-site morbidity.
Why it matters
This case highlights the feasibility of intraoral robotic supermicrosurgery, which may enhance reconstructive options and improve patient outcomes in oncological surgery.