A Scoping Review of Pain Management After Transoral Robotic Surgery

Otolaryngol Head Neck Surg. 2024 Dec;171(6):1617-1627. doi: 10.1002/ohn.871. Epub 2024 Jun 21.

Abstract

Objective: Pain following transoral robotic surgery (TORS) is a driver of adverse outcomes and can lead to readmission and treatment delays. A scoping review was conducted to characterize TORS-related pain and identify key management strategies utilized in the literature.

Data sources: OVID Medline, CINAHL, Cochrane, Pubmed, and Embase databases were queried.

Review methods: Two team members independently screened titles and abstracts and completed full-text reviews. Studies examining TORS for OPSCC with quantitative pain data were included. The study followed the PRISMA guidelines.

Results: A total of 1467 studies were imported for screening and 25 studies were ultimately included. The average study sample size was 89 participants. 68% were conducted in a single-center academic setting. Pain was assessed on varying timelines up to 3 years using 13 different metrics. Pain peaks days-weeks postoperatively and returns to baseline thereafter. Postoperative pain is a significant cause of morbidity and limited data exist about optimal management.

Conclusion: Prospective studies are needed to characterize and address TORS-related pain.

Keywords: TORS; odynophagia; oropharyngeal squamous cell carcinoma; pain; postoperative pain.

Publication types

  • Review

MeSH terms

  • Humans
  • Pain Management* / methods
  • Pain, Postoperative* / etiology
  • Robotic Surgical Procedures* / adverse effects