{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:12:00Z","timestamp":1792782720443,"version":"4.5.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Schleswig-Holstein - Campus Kiel","id":[{"id":"https:\/\/ror.org\/01tvm6f46","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Oral Maxillofac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgical management of malignant tumors in the orofacial region frequently necessitates extensive resection, resulting in significant functional and aesthetic morbidity. In younger patients, these sequelae carry a substantial psychosocial burden, emphasizing the need for minimally invasive reconstructive strategies that preserve quality of life while maintaining oncological safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 36-year-old female patient presented with a small 1\u2009\u00d7\u20091\u00a0cm swelling at the junction of the hard and soft palate on the left side. Incisional biopsy confirmed a malignant minor salivary gland tumor but did not permit definitive subtyping. The final diagnosis of a polymorphous adenocarcinoma (PAC), conventional subtype, was established only on the complete resection specimen. Following oncologically adequate resection, including partial hard palate and tuberosity removal, a 3\u2009\u00d7\u20094\u00a0cm defect was reconstructed with a free upper arm flap. Supermicrovascular anastomoses to the superior labial and facial arteries (vessel diameter\u2009~\u20090.2\u00a0mm) were performed via a transoral approach using the Symani\n                      <jats:sup>\u00ae<\/jats:sup>\n                      robotic surgical system with 20\u00d7 motion scaling. Venous anastomoses to the facial vein were completed end-to-end and end-to-side via the same intraoral access. Selective lymph node sampling of the four radiologically prominent ipsilateral level II lymph nodes through a minimal cervical incision showed no metastases, both on frozen section and on final histopathology (0\/4). Final histopathology demonstrated a 15\u00a0mm low-grade PAC resected in sano, without lymphovascular invasion, without unequivocal perineural infiltration and without bone invasion, classified as pT1 pN0 (0\/4) cM0, R0. Postoperative course was uneventful; functional rehabilitation including speech and swallowing therapy is ongoing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Robotic-assisted supermicrosurgery using the Symani\n                      <jats:sup>\u00ae<\/jats:sup>\n                      system enabled safe transoral free flap reconstruction of a posterior palatal defect with anastomoses at the sub 0.2\u00a0mm scale. This approach minimizes donor-site morbidity and demonstrates the feasibility of intraoral robotic supermicrosurgery as a novel reconstructive modality in head and neck oncology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10006-026-01639-0","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:40:40Z","timestamp":1789782040000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transoral robotic reconstruction of a posterior palatal defect using an upper arm flap following polymorphous adenocarcinoma resection: a novel minimally invasive approach"],"prefix":"10.1007","volume":"30","author":[{"given":"Henning","family":"Wieker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Wiltfang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aydin","family":"G\u00fclses","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6785-2676","authenticated-orcid":false,"given":"Johannes","family":"Spille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"issue":"4","key":"1639_CR1","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1111\/j.1600-0714.2007.00522.x","volume":"36","author":"A Buchner","year":"2007","unstructured":"Buchner A, Merrell PW, Carpenter WM (2007) Relative frequency of intra-oral minor salivary gland tumors: a study of 380 cases from northern California and comparison to reports from other parts of the world. 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Ethics approval was not required because the operation did not deviate from standard procedure.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"151"}}