Background: Excessive flexion of the neck and upper back from severe kyphosis of the thoracic spine may limit treatment options for head and neck cancer (HNC).
Methods: We describe an innovative approach to transoral robotic surgery (TORS) in a patient with severe thoracic kyphosis and oropharyngeal squamous cell carcinoma (OPSCC) who was unsuitable for definitive radiotherapy.
Results: Detailed discussion of management pathway, perioperative considerations, and surgical challenges is presented. TORS lateral oropharyngectomy was successfully performed with the robotic system docked from the caudal end in a modified Trendelenburg position.
Conclusions: With appropriate surgical and anesthetic planning, TORS for patients with severe thoracic kyphosis is a feasible and suitable treatment.
Keywords: anesthesia; ankylosing spondylitis; kyphosis; oropharyngeal cancer; robotic surgery.
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