Neck dissection through a facelift incision

Abstract

Obectives/Hypothesis To determine the feasibility and safety of neck dissection through a facelift incision. Study Design Prospective case series. Methods Cadavers and live subjects underwent neck dissection using a facelift incision with and without endoscopic assistance. In the live facelift neck dissection (FLND), the preoperative surgical indications, staging, adjuvant therapy, intraoperative technical procedure, pathology reports on lymph nodes, and short-term outcomes were reviewed. Results FLND was successfully performed in four cadavers and four live subjects, including selective (less than five neck levels removed) and comprehensive (levels I–V removed) neck dissections. All levels were accessible through this approach, with additional retraction required for levels I and IV. Endoscopic assistance was required in one neck dissection for adequate visualization. Short-term complications and number of excised lymph nodes were comparable to those from traditional neck dissection approaches. Conclusions Open neck dissection through a facelift incision is feasible and offers an alternate approach to traditional incisions. This can be performed without requiring robotic assistance and with endoscopic assistance only in certain cases. Endoscopic assistance can offer enhanced visualization of the surgical field and complement open direct approaches in neck dissection. Although FLND offers improved cosmetic outcomes when compared to those of traditional neck incisions, further study is required to determine its efficacy and indications.

The new era of robotic neck surgery: The universal application of the retroauricular approach

“…There were also no significant differences in the number of retrieved lymph nodes between the two methods of therapeutic neck dissection. Similar results were reported by others from different institutions who practiced the neck dissection via similar approach .…”

Robot-assisted level II-IV neck dissection through a modified facelift incision: initial North American experience

“…Although the feasibility of transaxillary thyroidectomy in North Americans was confirmed in this study and many others, one cannot assume the same for robotic‐assisted neck dissection. The feasibility of a retroauricular approach to the neck in the North American population has been further demonstrated by the group at Johns Hopkins, using open and endoscopic techniques which yielded adequate dissection of lymph node levels I–IV . Further, they have shown the feasibility of dissection of levels I–V using combined endoscopic and robot‐assisted dissection in cadaver studies through pre‐ and post‐auricular incisions .…”

Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

“…As the evolution of neck dissection continues, technological developments continue to shape the frontier of treating the neck in HNSCC. Transoral robotic surgery has gained popularity in some centers for treatment of oropharyngeal cancers; similarly, the use of robotic surgery has been introduced in neck dissection . The cost‐effectiveness and variable availability of this technology will continue to fuel debate as to its accepted utility in treating neck disease.…”