J Korean Assoc Oral Maxillofac Surg.  2014 Feb;40(1):27-31. 10.5125/jkaoms.2014.40.1.27.

Esthetic neck dissection using an endoscope via retroauricular incision: a report of two cases

• Kim JY
• Cho H
• Cha IH
• Nam W

• KMID: 1960969
• DOI: http://doi.org/10.5125/jkaoms.2014.40.1.27

Abstract

Various surgical techniques, such as endoscopic surgery and robotic surgery, are developed to optimize the esthetic outcome even in operations for malignancy. A modified face-lift or retroauricular approach are used to minimize postoperative scarring. Recently, robot-assisted surgery is being done in various fields and considered as favorable treatment method by many surgeons. However its high cost is a nonnegligible fraction for many patients. On the other hand, endoscopic surgery, which is cheaper than robotic surgery, is minimally invasive with contentable neck dissection. Although it is a difficult technique for a beginner surgeon due to its limited operation view, we suppose it as an alternative method for robotic surgery. Herein, we report two cases of endoscopic neck dissection via retroauricular incision with a discussion regarding the pros and cons of endoscopic neck dissection.

Keyword

Endoscopes; Neck dissection; Head and neck cancer

MeSH Terms

Cicatrix
Endoscopes*
Hand
Head and Neck Neoplasms
Humans
Neck Dissection*
Neck*

Figure

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  Fig. 1 Patient position and design for retroauricular approach. Patient laid supine position with neck extension. Outline of sternocleidomastoid muscle, omohyoid muscle, inferior border of mandible, and incision line were identified.

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  Fig. 2 Preparation for endoscopic neck dissection. Self-retaining retractor was fixed and endoscope was being inserted into level Ib area.

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  Fig. 3 Dissection on level Ib area (endoscopic view). Submandibular gland and facial artery were identified.

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  Fig. 4 Reconstructed tongue with radial forearm free flap (Case 2, postoperative day 17). Transplanted radial forearm free flap was survived successfully. Micro-anastomosis was performed via retroauricular approach. The color and texture was favorable.

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  Fig. 5 Clinical photograph (Case 1, frontal view, postoperative day 12). Postoperative scar is not identified at frontal photograph. Surgeons might achieve esthetic result after neck dissection.

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  Fig. 6 Clinical photograph (Case 1, lateral view, postoperative day 12). Postoperative scar can be hidden in hairline.

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  Fig. 7 Clinical photograph (Case 2, lateral view, postoperative day 17). The scar is relatively short compared with conventional methods and can also be hidden in hairline.

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