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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 4 - Head and Neck Surgery

Value of Exposure Trial of the Primary Site in Transoral Robotic Surgery

Sunday, October 12, 2025
1:48 PM - 1:54 PM EDT
Location: 127
Introduction: Transoral robotic surgery (TORS) success is associated with the achievement of adequate surgical exposure. A preoperative exposure trial with the retractor of choice may help improve surgical planning and outcomes. The objective of this study is to compare the frequency of close or positive margin status of patients who had adequate visualization on their exposure trial to patients who did not undergo an exposure trial.

Methods: Retrospective cohort study of all patients who underwent TORS from 2014-2024 at a tertiary care institution. Patient demographics, oncologic history, exposure trial results, and surgical outcomes were analyzed using Fischer’s exact test or one-way-ANOVA where appropriate.

Results: 214 patients underwent TORS from 2014-2024 for squamous cell carcinoma (SCC) of the BOT (23.4%), glossotonsillar sulcus (9.3%), palatine tonsil (53.3%), supraglottic larynx (12.1%), posterior pharyngeal wall (1.9%). A preoperative exposure trial was completed in 31.6% of cases, including 53.7% of BOT or glossotonsillar sulcus subsites. Patients with BOT or glossotonsillar sulcus tumors were more likely to have a positive or close, within 5mm, tumor margins if they did not undergo an exposure trial (p=0.02 and p=0.01, respectively). There was no difference in positive or close tumor margin status for tumors of other anatomic subsites (p=0.56 and p=0.26, respectively).

Conclusions: A preoperative exposure trial is associated with higher rates of achieving negative tumor margins in TORS cases for primary tumors of the BOT and glossotonsillar sulcus. Completion of an exposure trial may not be necessary for other primary tumor subsites that have consistently adequate exposure.

    Presenting Author(s)

  • Peter DA Eckard, MD

    Resident
    University of Arkansas for Medical Sciences
    Little Rock, Arkansas, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • AB

    Anna C. Benafield

    Medical Student
    UAMS
    Little Rock, Arkansas, United States

    Disclosure information not submitted.

  • DN

    Dang-Khoa Nguyen, MD

    Resident Physician
    University of Arkansas for Medical Sciences
    Little Rock, AR, United States

    Disclosure information not submitted.

  • Mauricio A. Moreno, MD

    Professor
    University of Arkansas for Medical Sciences
    Little Rock, AR, United States

    Disclosure information not submitted.

  • JS

    Jumin Sunde, MD

    University of Arkansas for Medical Sciences, USA

    Disclosure information not submitted.

    • Senior Author(s)

  • EV

    Emre A. Vural, MD

    Professor
    University of Arkansas for Medical Sciences
    Little Rock, AR, United States

    Disclosure information not submitted.