Medicine’s most important contribution to man is its relief from pain, disease and fear, as Hippocrates said centuries ago. Despite all the progress of modern Medicine, there is often a postponement of the surgical treatment of diseases on the part of the patients, mainly due to the fear of post-operative pain and suffering.

Head and neck surgery has progressed tremendously in recent years, with modern endoscopic techniques increasingly being applied instead of classic open surgical methods. With these techniques, the operation is more targeted at the affected organ, resulting in less damage to the surrounding healthy tissues.

THE endoscopic surgery of the nose – paranasal sinuses led to the much more functional, without external incisions treatment of diseases such as sinusitis, acute or chronic, polyps, benign and some malignant tumors, as well as scoliosis of the nasal septum. Thanks to magnification and lighting combined with micro-instruments and the use of Navigation, i.e. neuro-navigation, when there is an indication, this surgical approach enables the surgeon to treat the affected anatomical structures with precision and less risk of complications.

In the area of ​​the larynx thanks to endoscopic transoral laser surgery, which started in 1970, but has been done very systematically for 25 years, the treatment of benign diseases as well as cancer in the early stages has changed radically. The application of the laser, in addition to benign diseases involving cysts, polyps, Reinke’s swelling of the vocal cords, papillomas, paresis of the vocal cords and benign tumors, has radically changed the treatment of all malignancies of the pharynx-larynx-hypopharynx. Also, the laser has an excellent application in diseases of the nose (hypertrophy of the inferior nasal cavities, hereditary diseases such as Rendu Osler, which causes nosebleeds, and rhinophyma), as, of course, in the oral cavity, in terms of performing biopsies with local anesthesia and the removal of benign and malignant lesions from the mouth and tongue. So today it is possible, without external incisions and tracheostomy, to remove these tumors. Other advantages for the patient are that it allows for reoperation in case of local recurrence, particularly in vocal cord cancers, and does not limit other treatment options in patients with a second primary head and neck tumor. It also ensures satisfactory voice quality, limited swallowing disorder, low perioperative morbidity and minimizes the risk of intraoperative dispersion.

In recent years, its application has also begun in Otorhinolaryngology transoral robotic surgery, which has the advantage of using a 3D camera that enables the depth of the surgical field and anatomical structures to be assessed more clearly. Also, because it uses small tools with excellent rotation capability, it ensures better access to difficult corners of the special anatomical space called the upper airway. Its application today concerns benign conditions such as obstructive sleep apnea and early stages of cancer of the pharynx and larynx. It has also begun to play a very important role in the investigation of unknown primary head and neck cancer. The major benefit to the patient from the implementation of robotic surgery is the minimization of postoperative swelling, pain, bleeding and dysphagia.

For this reason, in recent years in all surgical specialties there is a tendency to achieve the same therapeutic result with the less mutilating method “Minimally invasive surgery”, which led to the development of more functional techniques.