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Purpose: This purpose of this case series is to present the first four cases utilizing micro-phonosurgical instrumentation designed specifically for use with a semi-flexible ‘robotic’ system—the Medrobotics Flex system and to evaluate the accessibility and feasibility of this platform in the context of transoral robotic surgery (TORS) for laryngeal surgery.Methods: Four patients (3 female, 1 male; age range 49–79 years) were operated by the senior author at CHL—a tertiary hospital centre between 2016 and 2017. The ‘robot’ was deployed in all cases to assess its accessibility and ability to perform surgery in the larynx.Results: All four patients were successfully treated using the system along with newly developed instrumentation specifically focused on phonosurgery.Conclusion: This series has demonstrated accessibility and ability for laryngeal surgery using a novel semi-rigid operator-controlled ‘robotic’ system. We encountered no device failures and were able to perform all the selected cases uneventfully. [ABSTRACT FROM AUTHOR]

We reviewed the results and side-effect profile of the Dysport® preparation of botulinum toxin A (BTA) in the management of the adductor spasmodic dysphonia. We performed 272 injection episodes in 68 patients, 42 (62%) female, 26 (38%) male. A total of 116 of these injections were unilateral, and 156 were bilateral; 94% of the injections were considered to have been successful with a voice score of 2 or higher. The mean duration of effect (injection intervals) was 128.8 days in the unilateral cohort and 118.7 days in the bilateral ( P > 0.05). We injected a relatively lower dose of BTA for unilateral injection episodes in our institution compared to those reported by others to produce comparable results and side-effect profiles. [ABSTRACT FROM AUTHOR]

Aims: To compare voice quality as defined by formant analysis using a sustained vowel in patients who have undergone a partial glossectomy with a group of normal subjects. Methods & Procedures: The design consisted of a single centre, cross-sectional cohort study. The setting was an Adult Tertiary Referral Unit. A total of 26 patients (19 males) who underwent partial glossectomy and 31 normal volunteers (18 males) participated in the study. Group comparisons using the first three formant frequencies (F1, F2 and F3) using linear predictive coding (Laryngograph Ltd, London, UK) were performed. The existence of any significant difference of F1, F2 and F3 between the two groups using the sustained vowel /i/ and the effects of other factors, namely age, first presentation versus recurrence, site (oral cavity, oropharynx), subsite (anterior two-thirds of the tongue, tongue base), stage, radiation, complication, and neck dissection, were analysed. Outcomes & Results: Formant frequencies F1, F2 and F3 were normally distributed. F1 and F2 were significantly different in normal males versus females. F1, F2 and F3 were not different statistically between male and female glossectomees. Comparison of only women showed significant differences between normal subjects and patients in F2 and F3, but none in F1. This was the opposite in men where F1 was significantly different. Age, tumour presentation, site, subsite, radiation and neck dissection showed no significant difference. Postoperative complications significantly affected the F1 formant frequency. Conclusions: The study found that the formant values in patients following a partial glossectomy were altered significantly as compared with the normal control subjects. Only gender and complications and not the age, site, subsite, radiation and neck dissection were seen to influence the formant scores. [ABSTRACT FROM AUTHOR]