I’m really trying to make a decision about which approach would be the best for surgery. I’ve heard from another group member that she had transoral robotic surgery and she recovered well and without nerve damage (and had it done bilaterally). I guess the new high tech approach is that they’re able to get to the base of the styloid and remove it with such accuracy that it avoids collateral damage. Any thoughts on this? I really value this group and all the insights everyone has given me, so thanks in advance!
I have not heard of robotic transoral surgery for ES specifically mentioned, but it sounds very interesting. Gives me something to read up on. Thank you.
We’ve had a couple of members who’ve had robotic ES surgery. I think both have had a good outcome. The first one was done a year or more ago, & I’m not sure we got any specific details about how much styloid was removed. The second one, & likely the one to which you refer, is adriene61.
The best I can tell you is that robotic surgeries of all kinds are still relatively new, & the outcome of any surgery is related to the skill of the surgeon doing the surgery whether robotic or “old style” i.e. w/o the robot.
I think what’s most important is that you have a surgeon in whom you feel confident & with whose surgical approach you agree. If the surgeon happens to be trained in robotic surgery then you get to experience surgery via the most modern tech. If the surgeon does not do robotic surgery then you will experience great manual skill & dexterity.
Robotic surgeries do tend to be less invasive which would predispose the patient to a lower likelihood of post op surgical “side effects”, however, I don’t know that there is enough significant statistical evidence to promote robotic over traditional surgeries at this time. I expect one day all surgeries will be done robotically though.
Thanks Jules! This is very helpful! I have an appt with Dr. Hackman on Dec 26th and I’m very excited about it. He seems very experienced, so I will keep the group updated on what he says and the plan.
Have you seen Adiene61’s post about robotic surgery? (In the thread Why do some doctors operate Extraoral and sone intraoral) Surgery’s just been done with Dr Hackman.
My surgeon is the head of Robotic head and neck surgery at UCLA but performed my surgery with conventional external process. I think it’s just very new to do with Robotics. I will be seeing him in 3 weeks and will ask about it and report back to the forum.
Dr Trevor Hackman in NC is who Adriene saw and I’m meeting with him 12/26 for a consult. I’m really interested to hear what everyone says. It seems to be the new trend due to less post surgical issues and faster recovery.
As I said before, the surgery is only as good as the surgeon doing it. Dr. Samji is extremely skilled w/o a robot. I did end up w/ some permanent nerve damage from my first ES surgery which Dr. Samji did, but you must understand the scenario: My glossopharyngeal nerve was wrapped around my styloid process like a vine. In order to be able to cut my styloid back, Dr. Samji had to unwrap that nerve. He did it as carefully as possible & the consequences were a half paralyzed tongue for 6-9 months & a bit of residual facial pain which I am easily able to live with. I’m not sure how a robot could have prevented the post op troubles I have/had. The nerve would still have had to be dealt with. It was an unknown prior to the time Dr. Samji opened up my neck. If my surgery had been done intraorally/robotically, I shudder to think what problems I might have now. Those nerves aren’t visible via the intraoral approach which seems to be the only way surgeons doing robotic surgery approach ES.
I’m not trying to scare you, but there are always things that can’t be seen until a person has “gone under the knife”. The external approach allows for visualization & monitoring of nerves & vascular tissues which the intraoral approach does not. I chose the surgeon & approach I agreed with the most, & it paid off for me. That’s not to say my decision is the right one for others. It is a difficult choice. Though recovery is a bit slow either way, the first week post op is really the only truly tough period. By week 2 things begin to gradually improve.
i.e. w/o the robot.
