Potential of robotic systems in phonosurgery.

There has been rapid growth in the utilization of robotic surgery in the head and neck. Its utilization in the phonosurgical space has lagged owing to difficulty with access and exposure to the laryngeal site, small working space due to the size of the larynx and the need to work around an endotracheal tube. The goal of this work is to explore recent developments in robotic microlaryngeal surgery. At this time robotic instrumentation is available; however, the range of instruments is not as extensive to match the current microlaryngeal instrumentation that exists for traditional endoscopic surgery. Studies have demonstrated the ability to perform phonosurgery safely with currently available robotic systems but exposure is less than ideal. Work is been undertaken to develop specialized transoral robotic retractors which will improve visualization and allow the robotic instrument to reach the glottis, which has traditionally been the most difficult to area to access.  Additional studies will be needed to assess the application of these systems to more patient populations, and prospective research will be required to compare outcomes of traditional phonosurgery to robotic phonosurgery.