{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:22:36Z","timestamp":1788787356005,"version":"build-2803163510"},"reference-count":46,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objectives: This review summarizes current evidence on robotic-assisted upper airway and neck surgery in pediatric patients, highlighting clinical indications, outcomes, limitations, and areas for future research. Methods: A systematic review was conducted in accordance with PRISMA guidelines, including studies on robotic surgery for pediatric patients (\u226418 years) with upper airway conditions and cervical pathologies. Data on study characteristics, patient demographics, surgical details, outcomes, and robotic system advantages or limitations were extracted. Results: Twenty studies met inclusion criteria, comprising 104 pediatric patients who underwent 110 robotic procedures, mostly transoral robotic surgery (TORS) for base of tongue, laryngeal, and cervical pathologies. The Da Vinci Si was the most used system. The mean operative time was ~74 min, with minimal blood loss and no intra\/post operative tracheostomies. Reported advantages included enhanced visualization, precision, and reduced morbidity. Limitations involved size mismatches, limited working space, and high costs. Follow-up (mean 11.4 months) revealed no recurrences, confirming feasibility and safety in selected pediatric cases. Conclusions: Robotic-assisted surgery appears to be a feasible and safe option for managing pediatric upper airway and neck conditions, offering promising functional and aesthetic outcomes with low complication rates. However, its use is currently limited by anatomical constraints, high costs, and the need for surgeon training. Long-term prospective studies with larger cohorts are needed to confirm its efficacy and define its role compared to traditional techniques.<\/jats:p>","DOI":"10.3390\/children12060765","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T06:19:28Z","timestamp":1749795568000},"page":"765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Current Applications and Outcomes of Robotic Surgery in Pediatric Upper Airway and Neck Procedures: A Systematic Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-1042","authenticated-orcid":false,"given":"Irene Claudia","family":"Visconti","sequence":"first","affiliation":[{"name":"GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology\u2013Head and Neck Surgery, 00162 Rome, Italy"},{"name":"Otorhinolaryngology Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marella","family":"Reale","sequence":"additional","affiliation":[{"name":"GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology\u2013Head and Neck Surgery, 00162 Rome, Italy"},{"name":"Otorhinolaryngology Unity, Head and Neck Department, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Dallari","sequence":"additional","affiliation":[{"name":"GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology\u2013Head and Neck Surgery, 00162 Rome, Italy"},{"name":"Department of Otolaryngology Head and Neck Surgery, Santa Maria delle Croci Hospital, AUSL della Romagna, 48121 Ravenna, Italy"},{"name":"Young Confederation of European ORL-HNS, Y-CEORL-HNS, 1040 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6490-1746","authenticated-orcid":false,"given":"Eleonora M. C.","family":"Trecca","sequence":"additional","affiliation":[{"name":"GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology\u2013Head and Neck Surgery, 00162 Rome, Italy"},{"name":"Department of Otorhinolaryngology and Maxillofacial Surgery, IRCCS Research Hospital Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo (FG), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella Miriam","family":"Di Lullo","sequence":"additional","affiliation":[{"name":"GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology\u2013Head and Neck Surgery, 00162 Rome, Italy"},{"name":"Otorhinolaryngology-Head and Neck Surgery Unit, AORN \u201cSan Pio\u201d, 82100 Benevento, Italy"},{"name":"CEINGE-Advanced Biotechnology, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Turri-Zanoni","sequence":"additional","affiliation":[{"name":"GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology\u2013Head and Neck Surgery, 00162 Rome, Italy"},{"name":"Department of Otolaryngology-Head and Neck Surgery, ASST Lariana, Ospedale Sant\u2019Anna, University of Insubria, 22042 Como, Italy"},{"name":"Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5435-685X","authenticated-orcid":false,"given":"Michele","family":"Gaffuri","sequence":"additional","affiliation":[{"name":"GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology\u2013Head and Neck Surgery, 00162 Rome, Italy"},{"name":"Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico of Milan, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"ref_1","first-page":"7","article-title":"Transoral robotic surgery in head neck cancer management","volume":"11","author":"Kwong","year":"2015","journal-title":"B-ENT"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1177\/0194599816630962","article-title":"Transoral Robotic Surgery for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis","volume":"154","author":"Justin","year":"2016","journal-title":"Otolaryngol. 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