Treatment of cleft lip alveolus and/or palate includes surgical repair to treat communication-related outcomes such as velopharyngeal insufficiency and otological dysfunction. Robot-assisted surgery has recently evolved into a promising adjunct to conventional surgery, particularly for complex procedures such as transoral (reconstructive) surgery. This structured literature review aims to investigate whether robot-assisted transoral cleft palate repair enhances communication (i.e., speech and otological) outcomes compared to conventional manual cleft palate surgery. A literature search was performed using PubMed, Embase, the Cochrane Library and Google Scholar. Primary outcomes were the change in cleft speech characteristics and otological disease after robot-assisted cleft palate surgery versus manual cleft palate surgery. The available evidence on communication-related outcomes remains sparse. Six relevant articles were included. In only one study, transoral robotic cleft surgery (TORCS) significantly reduced otitis media with effusion (OME), need for ventilation tubes and hearing threshold within 2 years post-surgery. No postoperative speech or velopharyngeal outcomes were reported. In conclusion, transoral robotic cleft surgery (TORCS) appears safe and feasible for repair of a cleft palate. It provides superior intraoral view and improved surgeon ergonomics. Current drawbacks are the costs and the available tools, the extended surgical duration and the lack of haptic feedback, which limit the current clinical applicability of TORCS. Based on limited clinical evidence, TORCS may support faster recovery of Eustachian tube function and hearing, but no conclusions on speech outcomes can yet be drawn.

Background: Osteoarthritis of the hand and wrist is common and can have a significant impact on quality of life. Since the carpus consists of multiple bony structures, osteoarthritis can exist in many forms. Arthroplasty using implants has become the standard treatment for many larger joints. In carpal arthroplasty, many implants exist. To determine the most suitable implant in each individual patient, knowledge of the possibilities is important. This article aims to provide an overview of the more commonly used implants in carpal arthroplasty. Methods: This narrative review describes all types of carpal implants, namely, total wrist implants, first carpometacarpal implants, the Amandys® implant, the Pyrocardan® disc, pyrocarbon capitate resurfacing implants, the adaptive proximal scaphoid implant, and total carpal replacement. A literature search was conducted separately for each implant. All studies investigating implant performance were included. Results: Naturally, each implant showed different results. Implant arthroplasty is most often compared to either arthrodesis or resection arthroplasties. For joint replacing implants like total wrist implants or first carpometacarpal implants, the use of joint replacing implants seems to be beneficial in certain populations. Joint resurfacing implants show similar functional results to the comparable non-implant options. However, research on these implants is less prevalent. Regarding all implants, complication rates seemed either similar to or in favor of non-implant options. Almost no studies found a lower complication rate for implant usage. Conclusions: Carpal implants are a valid option in carpal osteoarthritis. Implants seem to perform comparably to non-implant options. Careful patient selection is required, especially since implants may carry a higher risk of complications.